2013-2014年ICU患者病原菌分布及耐药性分析

发布时间：2018-06-17 02:35

本文选题：重症监护病房 + 病原菌　；参考：《中华医院感染学杂志》2016年12期

【摘要】：目的分析医院ICU入住患者的菌群分布和耐药性,为临床治疗提供依据。方法选择2013-2014年入住医院ICU病原菌培养结果阳性患者3 688例,用BACTEC FX全自动细菌培养系统和VITEK-2Compact全自动细菌鉴定仪进行菌株鉴定及药敏分析,将病原菌的分布及药敏结果进行分析。结果 3 688例患者标本中以痰液标本最多,占53.38%;其次为血液及脓汁,分别占15.55%及5.27%;共分离出病原菌3 688株,其中革兰阴性菌占64.30%,革兰阳性球菌株占23.44%,真菌占11.27%;主要革兰阳性菌对青霉素G、红霉素、四环素的耐药率均60.0%,鲍氏不动杆菌对头孢吡肟、亚胺培南和环丙沙星的耐药率均90.0%。结论医院ICU患者感染病原菌仍以革兰阴性菌为主,但耐药率有上升趋势,革兰阴性菌中以鲍氏不动杆菌为主,真菌感染有下降趋势,应加强ICU主要致病菌及其耐药性监测,合理使用抗菌药物,减少医院感染及耐药菌产生。
[Abstract]:Objective to analyze the distribution of bacteria and drug resistance of ICU patients in order to provide evidence for clinical treatment. Methods A total of 3688 patients with positive results of pathogen culture in ICU from 2013 to 2014 were selected. The bacterial strains were identified by BACTEC FX automatic bacterial culture system and VITEK-2Compact automatic bacterial identification instrument. The distribution of pathogens and the results of drug sensitivity were analyzed. Results among the 3 688 patients, the sputum was the most, accounting for 53.38, blood and pus accounted for 15.55% and 5.27 respectively, and 3 688 strains of pathogenic bacteria were isolated. Gram-negative bacteria accounted for 64.30m, Gram-positive bacteria 23.44m, fungi 11.27.The main Gram-positive bacteria were resistant to penicillin G, erythromycin and tetracycline, and Acinetobacter baumannii was resistant to cefepime, imipenem and ciprofloxacin. Conclusion Gram-negative bacteria are still the main pathogens in nosocomial ICU, but the resistance rate of Gram-negative bacteria is increasing. Acinetobacter baumannii is the main bacteria in Gram-negative bacteria, and fungal infection is decreasing. The surveillance of main pathogenic bacteria and their drug resistance in ICU should be strengthened. Rational use of antimicrobial agents to reduce nosocomial infection and drug-resistant bacteria production.
【作者单位】：哈尔滨医科大学附属第一医院重症医学科;哈尔滨医科大学附属第一医院检验科;
【基金】：黑龙江省卫生厅科研基金资助项目(QC2012C014)
【分类号】：R446.5

【参考文献】