ICU患者下呼吸道感染病原菌与耐药性分析

发布时间：2018-09-05 21:10

【摘要】：目的回顾性分析ICU患者医院下呼吸道感染的病原菌分布及耐药性,探讨预防ICU患者医院下呼吸道感染的对策,降低ICU患者医院感染率。方法回顾性分析医院2013年10月-2015年10月ICU病房收治的864例患者,统计医院感染患者病原菌检出情况及相应病原菌的耐药情况,采用Logistic分析ICU患者医院下呼吸道感染的相关因素和危险因素,探讨临床应采取的预防措施。结果发生医院下呼吸道感染56例,医院感染率为6.48%,患者共检出68株病原菌,其中革兰阳性菌22株占32.36%,革兰阴性菌38株占55.88%,真菌8株占11.76%。金黄色葡萄球菌、凝固酶阴性葡萄球菌对环丙沙星、阿米卡星有较高的耐药率,对头孢哌酮/舒巴坦、阿莫西林/克拉维酸、左氧氟沙星、头孢哌酮的耐药率较低;肺炎克雷伯氏菌、大肠埃希菌对青霉素耐药率较高,对阿莫西林/克拉维酸、亚胺培南/西司他丁、万古霉素的耐药率较低。结论 ICU患者易并发医院下呼吸道感染,临床应针对患者的易感因素,采取对应措施进行预防,降低感染率,提高患者治疗效果。
[Abstract]:Objective to analyze the distribution of pathogens and drug resistance of ICU patients with nosocomial lower respiratory tract infection, and to explore the countermeasures to prevent nosocomial lower respiratory tract infection in patients with ICU and to reduce the nosocomial infection rate of ICU patients. Methods from October 2013 to October 2015, 864 patients in ICU ward were retrospectively analyzed. The detection of pathogenic bacteria and the drug resistance of the corresponding pathogens were statistically analyzed in the patients with nosocomial infection. Logistic was used to analyze the related factors and risk factors of nosocomial lower respiratory tract infection in patients with ICU. Results there were 56 cases of nosocomial lower respiratory tract infection, the nosocomial infection rate was 6.48%. 68 strains of pathogenic bacteria were detected, of which 22 strains were Gram-positive bacteria, 38 strains were Gram-negative bacteria, and 8 strains were fungi, which accounted for 11.76%. Staphylococcus aureus, coagulase-negative staphylococcus had high resistance to ciprofloxacin and amikacin, and the resistance rate to cefoperazone / sulbactam, amoxicillin / clavulanic acid, levofloxacin and cefoperazone was low. The resistance rate of Klebsiella pneumoniae to penicillin was higher than that of amoxicillin / clavulanic acid imipenem / cilastatin and vancomycin. Conclusion ICU patients are prone to nosocomial lower respiratory tract infection.
【作者单位】：天津医科大学第二医院ICU;天津医科大学第二医院内科;天津医科大学口腔医院颌面外科;
【基金】：天津市卫生局基金资助基金(TJ211234)
【分类号】：R459.7

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