我院ICU脑干出血患者医院感染病原菌分布及耐药性分析

发布时间：2018-04-23 21:35

本文选题：重症医学科 + 脑干出血　；参考：《中国药房》2017年02期

【摘要】：目的:为临床合理使用抗菌药物提供参考。方法:收集2014年1月-2015年12月我院重症医学科(ICU)283例脑干出血患者的病原学资料,回顾性分析其医院感染病原菌的分布特征及耐药情况。结果:283例患者中,确诊为医院感染的患者共205例,感染率为72.44%;共送检临床标本765份,以痰液(60.00%)、血液(14.38%)和胆汁(9.54%)等标本为主;共检出病原菌765株,包括以肺炎克雷伯菌为主的革兰氏阴性菌496株(64.84%),以金黄色葡萄球菌为主的革兰氏阳性菌238株(31.11%)和以白色假丝酵母菌为主的真菌31株(4.05%);共检出产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌89株、产ESBLs大肠埃希菌23株、耐甲氧西林金黄色葡萄球菌87株。肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类药物敏感(耐药率5%);金黄色葡萄球菌、表皮葡萄球菌和产色葡萄球菌对常用抗菌药物的耐药率均较高,但对万古霉素敏感(耐药率均为0)。结论:我院ICU脑干出血患者医院感染的主要病原菌为革兰氏阴性菌,其耐药情况及产酶情况不容乐观;对主要病原菌敏感性较高的药物包括碳青霉烯类药物和万古霉素等。临床应加强监测病原菌的耐药特征,有针对性地选用抗菌药物。
[Abstract]:Objective: to provide reference for rational use of antibiotics in clinical practice. Methods: the pathogenic data of 283 patients with brain stem hemorrhage in the Department of severe medicine (ICU) of our hospital in January 2014 -2015 December were collected, and the distribution characteristics and drug resistance of the pathogenic bacteria of the hospital infection were analyzed retrospectively. Results: among the 283 patients, 205 cases of nosocomial infection were diagnosed and infected. The rate was 72.44%; a total of 765 clinical specimens were tested, with sputum (60%), blood (14.38%) and bile (9.54%), 765 strains of pathogenic bacteria were detected, including 496 Gram-negative bacteria with Klebsiella pneumoniae (64.84%), 238 (31.11%) and Candida albicans with Staphylococcus aureus as the main body and mainly Candida albicans. 31 strains of fungi (4.05%); 89 strains of Klebsiella pneumoniae produced by broad-spectrum beta lactamase (ESBLs), 23 strains of Escherichia coli, 87 strains of methicillin resistant Staphylococcus aureus. Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Acinetobacter Bauman were sensitive to carbapenems (resistance rate 5%); Staphylococcus aureus The resistance rate of Staphylococcus epidermidis and Staphylococcus aureus to commonly used antibiotics is high, but it is sensitive to vancomycin (the resistance rate is 0). Conclusion: the main pathogenic bacteria of hospital infection in ICU brain stem hemorrhage patients in our hospital are Gram-negative bacteria, the drug resistance and enzyme production are not optimistic, and the drugs with high sensitivity to the main pathogens are high. Including carbapenem and vancomycin, we should strengthen the monitoring of drug-resistant characteristics of pathogens and select antibiotics selectively.

【作者单位】：青岛大学附属医院医院感染管理部;青岛大学附属医院预防保健科;青岛大学附属医院药学部;
【基金】：山东省医学领军人才培养基金资助项目(No.ts20110814)
【分类号】：R743.34

【相似文献】