ICU住院患者感染病原菌分布及耐药性分析

发布时间：2019-04-12 18:46

【摘要】：目的分析ICU住院患者感染病原菌分布及耐药性,为抗菌药物的合理应用提供依据。方法选取2013年1月-2016年5月医院ICU住院的72例感染患者,进行细菌分离及鉴定,并分析感染患者的病原菌分布及药敏试验结果。结果 ICU住院的72例感染患者的感染部位以呼吸道、泌尿道、消化道为主,分别占56.9%、26.4%和15.3%,标本来源以痰液、尿液、血液为主,分别占52.7%、27.5%和18.7%;共分离病原菌91株,其中革兰阴性菌55株占60.4%,革兰阳性菌34株占37.4%,真菌2株占2.2%;革兰阴性菌中大肠埃希菌和肺炎克雷伯菌检出率较高,分别为30.8%和16.5%,革兰阳性菌中肠球菌属和金黄色葡萄球菌检出率较高,分别为22.0%和9.9%,真菌中白假丝酵母菌占2.2%;革兰阴性菌对氨基糖苷类、喹诺酮类、第三代头孢菌素等抗菌药物耐药率较高,部分可达100.0%,而对美罗培南、亚胺培南、阿米卡星及头孢哌酮/舒巴坦等仍较敏感,革兰阳性菌对青霉素、克林霉素等普遍耐药,但对万古霉素、替考拉宁、利福平等仍较敏感。结论 ICU住院患者发生感染以呼吸道感染最为常见,泌尿系感染次之;在分离菌株中仍以革兰阴性菌为主,对美罗培南、亚胺培南、阿米卡星及头孢哌酮/舒巴坦等抗菌药物仍较敏感,可以为临床医师的经验性用药提供依据。
[Abstract]:Objective to analyze the distribution and drug resistance of pathogenic bacteria in ICU inpatients so as to provide evidence for the rational use of antibiotics. Methods from January 2013 to May 2016, 72 patients with ICU infection were selected for bacterial isolation and identification. The distribution of pathogenic bacteria and the results of drug sensitivity test were analyzed. Results the main infection sites were respiratory tract, urinary tract and digestive tract, accounting for 56.9%, 26.4% and 15.3%, respectively. The main source of ICU infection was sputum, urine and blood, accounting for 52.7%, respectively. 27.5% and 18.7%; A total of 91 strains of pathogenic bacteria were isolated, of which 55 were Gram-negative bacteria (60.4%), 34 were Gram-positive bacteria (37.4%) and 2 were fungi (2.2%). The positive rates of Escherichia coli and Klebsiella pneumoniae in gram-negative bacteria were 30.8% and 16.5%, respectively. The detection rates of Enterococcus and Staphylococcus aureus in gram-positive bacteria were 22.0% and 9.9%, respectively, and the positive rates of Escherichia coli and Klebsiella pneumoniae in gram-negative bacteria were 30.8% and 16.5%, respectively. Candida albicans accounted for 2.2% of the fungi. Gram-negative bacteria were highly resistant to aminoglycosides, quinolones and third-generation cephalosporins, some of which were 100.0%, but were still sensitive to meropenem, imipenem, amikacin and cefoperazone / sulbactam. Gram-positive bacteria were generally resistant to penicillin and clindamycin, but were still sensitive to vancomycin, teicoplanin and rifampicin. Conclusion Respiratory tract infection is the most common infection in inpatients with ICU, followed by urinary tract infection. Gram-negative bacteria were still dominant in isolated strains. They were still sensitive to meropenem, imipenem, amikacin and cefoperazone / sulbactam.
【作者单位】：东阳市横店集团医院ICU;东阳市横店集团医院检验科;
【分类号】：R459.7

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