呼吸科重症监护病房患者痰标本分离细菌及其耐药率变迁

发布时间：2018-01-13 08:09

本文关键词：呼吸科重症监护病房患者痰标本分离细菌及其耐药率变迁　出处：《中国感染控制杂志》2017年11期 　论文类型：期刊论文

【摘要】：目的了解呼吸科重症监护病房(RICU)患者痰标本分离细菌及其耐药率变迁情况。方法收集2013年1月—2015年12月某三甲医院RICU557例住院患者痰标本分离的非重复细菌,对菌株的耐药性进行分析。结果共分离1 131株细菌,其中革兰阳性(G+)菌212株(18.8%),革兰阴性(G-)菌919株(81.2%)。最常见的5种细菌为鲍曼不动杆菌(30.2%)、铜绿假单胞菌(21.1%)、金黄色葡萄球菌(18.2%)以及肠杆菌科细菌中的肺炎克雷伯菌(9.8%)和黏质沙雷菌(8.3%)。2013—2015年金黄色葡萄球菌和非发酵菌分离率未见明显变化趋势,但肠杆菌科细菌分离率有上升趋势。药敏试验结果显示,鲍曼不动杆菌及铜绿假单胞菌对亚胺培南、左氧氟沙星、庆大霉素耐药率较高,均60%,而铜绿假单胞菌对头孢他啶耐药率相对较低,且呈下降趋势(由59.4%降至37.5%);耐甲氧西林金黄色葡萄菌(MRSA)检出率为96.1%,对替加环素、万古霉素、利奈唑胺、复方磺胺甲口恶唑、喹奴普丁/达福普汀的敏感率接近100%;肠杆菌科细菌对磺胺类药物耐药率降低(由55.6%降至14.3%),但对头孢他啶、头孢噻肟、亚胺培南、左氧氟沙星、庆大霉素耐药率均60%。结论该院RICU患者痰标本分离细菌以鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌为主,分离细菌的耐药情况严重。
[Abstract]:Objective to investigate the respiratory intensive care unit (ICU). Methods the sputum samples of RICU557 patients from January 2013 to December 2015 were collected. Results A total of 1 131 strains of bacteria were isolated, among which 212 strains of Gram-positive G) were isolated. The five most common bacteria were Acinetobacter baumannii 30.2 and Pseudomonas aeruginosa 21.1. Staphylococcus aureus 18.2) and Klebsiella pneumoniae in Enterobacteriaceae) and M. Shareh 8.3). The isolation rate of Staphylococcus aureus and non-fermentative bacteria between 2013 and 2015 showed no significant change trend. The drug sensitivity test showed that Acinetobacter baumannii and Pseudomonas aeruginosa were resistant to imipenem, levofloxacin and gentamicin with a high resistance rate of 60%. The resistance rate of Pseudomonas aeruginosa to ceftazidime was relatively low (from 59.4% to 37.5%). The positive rate of MRSA-resistant to methicillin-resistant grapevine aureus was 96.1. Tegacycline, vancomycin, linazolamide, compound sulfamethoxazole were detected. The sensitivity rate of quinopudine / dfoprtin was close to 100. The resistance rate of Enterobacteriaceae to sulfamide was decreased (from 55.6% to 14.3%, but to ceftazidime, cefotaxime, imipenem, levofloxacin). Conclusion Acinetobacter baumannii Pseudomonas aeruginosa and Staphylococcus aureus are the main bacteria isolated from sputum specimens of RICU patients in this hospital.
【作者单位】：南京大学医学院附属金陵医院;
【分类号】：R446.5
【正文快照】： 细菌对抗菌药物耐药是临床上面临的一个严峻问题,重症监护病房(intensive care unit,ICU)患者病情危重、免疫力低下、各种有创性的诊疗操作导致皮肤黏膜屏障被破坏,容易发生各种细菌感染,而抗菌药物滥用及不合理使用导致细菌耐药情况非常严重。据文献[1-4]报道,ICU住院患者中

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