ICU医院感染患者病原菌分布特点及血清PCT变化与预后临床价值分析

发布时间：2018-01-17 03:27

本文关键词：ICU医院感染患者病原菌分布特点及血清PCT变化与预后临床价值分析　出处：《中华医院感染学杂志》2017年13期 　论文类型：期刊论文

【摘要】：目的探讨ICU医院感染患者病原菌分布特点及血清降钙素原(PCT)变化与预后临床价值。方法选取医院2015年1月-2016年12月ICU感染患者98例作为观察组,另选医院同期健康体检者73例作为对照组,采集患者血液/痰液标本分离病原菌,进行细菌鉴定,其中革兰阳性菌药敏试验采用GN201法,革兰阴性菌药敏试验采用GP法,以纸片扩散法进行药敏试验;同时采集入组研究对象外周静脉血,分离血清,采用半定量固相免疫测定法测定血清PCT含量,比较两组血清PCT水平变化及死亡组和存活组血清PCT水平变化。结果 ICU感染患者98例检出病原菌107株,其中革兰阴性菌61株占57.01%,革兰阳性菌38株占35.51%,真菌8株占7.48%;主要革兰阴性菌对头孢曲松和头孢噻肟耐药率较高;主要革兰阳性菌对青霉素和红霉素耐药率较高;观察组血清PCT水平高于对照组(P0.05);死亡患者血清PCT水平高于存活患者(P0.05)。结论 ICU医院感染患者病原菌分布以革兰阴性菌为主,其血清PCT水平明显上升,且其水平对患者预后具有积极作用,故而具有重要临床研究价值。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and serum procalcitonin in patients with ICU nosocomial infection. Methods 98 patients with ICU infection from January 2015 to December 2016 were selected as observation group. Another 73 healthy people were selected as control group. Blood / sputum samples of patients were collected to isolate pathogenic bacteria and bacteria were identified. Gram-positive bacteria susceptibility test was performed by GN201 method. Gram-negative bacteria susceptibility test was performed by GP method and disk diffusion test. At the same time, the peripheral venous blood was collected and the serum was isolated. The serum PCT content was determined by semi-quantitative solid-phase immunoassay. The changes of serum PCT level and serum PCT level in death group and survival group were compared between the two groups. Results 107 strains of pathogenic bacteria were detected in 98 patients with ICU infection. Among them, 61 strains of Gram-negative bacteria accounted for 57.01%, 38 strains of Gram-positive bacteria accounted for 35.51%, and 8 strains of fungi accounted for 7.48%. The resistance rate of main Gram-negative bacteria to ceftriaxone and cefotaxime was higher. The resistant rate of main gram-positive bacteria to penicillin and erythromycin was higher. The serum PCT level in the observation group was higher than that in the control group (P 0.05). The serum PCT level of the dead patients was higher than that of the surviving patients (P 0.05). Conclusion the distribution of pathogenic bacteria in patients with ICU nosocomial infection is mainly Gram-negative bacteria, and the serum PCT level is obviously increased. And its level has a positive effect on the prognosis of patients, so it has important clinical research value.
【作者单位】：广东省人民医院(广东省医学科学院)急危重症医学部;
【基金】：广东省医学科研技术基金资助项目(A20160800)
【分类号】：R446.5
【正文快照】： 重症监护室(ICU)收治的患者具有病情危重特点,且伴各种循环衰竭、呼吸衰竭,大部分需各种抗菌药物治疗、各种侵入性操作、治疗时间长、医院感染率高于其他科室[1-2]。医院感染主要是指住院患者于医院内获得的感染,不包括入院前存在的感染或者入院时已存在的感染[3]。ICU医院感

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