摘要
目的:探讨某院神经外科重症监护室(NICU)下呼吸道感染患者的主要病原菌及耐药情况,为临床选择药物提供数据支持。方法:回顾性分析2016年1月~2020年12月5年内的NICU患者中下呼吸道感染病原菌的种类及耐药性。结果:共分离出病原菌749株,革兰阴性杆菌占74.63%,革兰阳性球菌占18.83%,真菌占6.54%,以革兰阴性菌为主。分离出的前五位病原菌依次为肺炎克雷伯菌(204株)、鲍曼不动杆菌(113株)、金黄色葡萄球菌(104株)、铜绿假单胞菌(72株)、大肠埃希菌(42株)。其中,耐碳青霉烯类鲍曼不动杆菌的检出率为68.14%,耐甲氧西林金黄,色葡萄球菌(MRSA)的检出率为33.65%,耐碳青霉烯类铜绿假单胞菌检出率为23.61%,耐碳氢霉烯类肠杆菌科检出率为1.16%,肺炎克雷伯菌产超广谱内酰胺酶(ESBL)的检出率为11.27%,大肠埃希菌产ESBL的检出率为21.43%。结论:NICU内患者下呼吸道感染以多重耐药的革兰阴性杆菌的比例相对较高,临床应根据微生物出具的药敏报告合理选择抗菌药物,同时采取有效干预措施,控制和减少医院感染的发生。
Objective:To investigate the main pathogens and drug resistance causing lower respiratory tract infections in neurosurgery intensive care unit(NICU),and provide data support for clinical selection of drugs.Methods:A retrospective analysis of the bacterial speciesand drug resistance of pathogens causing lower respiratory tract infectionin NICU patients from January 2016 to December 2020 was performed.Results:A total of 749 strains of pathogenic bacteria were isolated.Gram-negative bacilli accounted for 74.63%,Gram-positive cocci accounted for 18.83%,and fungi accounted for 6.54%,Gram-negative bacteria were the main ones.The top five isolated pathogenic bacteria were Klebsiellapneumoniae(204strains),Acinetobacter baumannii(113 strains),Staphylococcus aureusi(104 strains),Pseudomonas aeruginosa(72 strains),Escherichia coli(42 strains)in descending order.Among them,the detection rate of carbapenemresistant Acinetobacter baumannii was 68.14%,the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 33.65%,the carbapenem-resistant Pseudomonas aeruginosa rate was 23.61%,the detection rate of hydrocarbon-resistant enterobacteriaceae was 1.16%,the Klebsiella Pneumoniae producing extended-spectrum lactamase(ESBL)rate was 11.27%and that of extended-spectrum lactamase(ESBL)produced by Escherichia coli was 21.43%.Conclusion:After lower respiratory tract bacterial culture,it was found that the proportion of lower respiratory tract infections in NICU patients was relatively high with multi-drug-resistant gram-negative bacilli.The clinic should select antibacterial drugs reasonably according to the drug sensitivity report issued by microorganisms,and take effective intervention measures to control and reduce the incidence of nosocomial infections.
作者
杨守磊
YANG Shou-lei(Department of Clinical Laboratory,Xintai People's Hospital,Shandong Xintai 271200)
出处
《医学检验与临床》
2022年第2期39-42,共4页
Medical Laboratory Science and Clinics
关键词
神经外科重症监护室
下呼吸道感染
主要病原菌
耐药性
Neurosurgery intensive care unit
Lower respiratory tract infection
Main pathogenic bacteria
Drug resistance
