摘要
目的 监测呼吸内科重症监护室 ( ICU)中应用呼吸机治疗患者呼吸道感染菌的分布 ,测定其药敏 ,为临床治疗提供依据。方法 采集患者的痰、下呼吸道分泌物、保护性毛刷刷检物、肺泡灌洗液和气囊上滞留物标本 ,分离菌应用 API细菌鉴定系统鉴定 ,药敏检测应用 Kirby- Bauer纸片扩散法 ,统计应用 WHONET5 .1软件。结果革兰阴性杆菌中以铜绿假单胞菌和鲍氏不动杆菌居多 ,分别占 32 .9%和 2 8.2 % ,革兰阳性球菌中以金黄色葡萄球菌居多 ,占 3.9% ;铜绿假单胞菌对 IMP和 AMK较敏感 ,耐药率分别为 2 8.9%和 18.4 % ;鲍氏不动杆菌对IMP较敏感 ,耐药率为 14 .6 % ,对 AMP、CEC、CTX10 0 %耐药 ;金黄色葡萄球菌对 VAN10 0 %敏感 ,对 NIT和MEM的耐药率分别为 16 .7%和 11.1%。结论 ICU中应用呼吸机治疗患者的感染菌多为多重耐药菌 ,一旦怀疑感染 ,则应立即经验性应用足量的广谱抗菌药物 。
OBJECTIVE To investigate the distribution feature and resistance pattern of isolates from lower respiratory tract of patients with mechanical ventilation in ICU. METHODS To collect the specimens of sputum, lower respiratory tract secretion, bronchoscopic protected specimen brush and bronchoalveolar lavage. The isolates were identified by API bacteria identitive system. Bacterial susceptibility testing was done by Kirby-Bauer method and the susceptible results were statistically analyzed by WHONET 5.1 software. RESULTS A total of 461 strains were detected. The dominant strains of Gram-negative bacilli were Pseudomonas aeruginosa and Acinetobacter baumannii. Their strains accounted for 32.9% and 28.2%, respectively. The dominant strains of Gram-positive cocci were Staphylococcus aureus, accounted for 3.9%. The in vitro activity of antibiotic drug was done, IMP and AMK were more susceptible against P. aeruginosa, their resistance rate was 28.9% and 18.4%, respectively. IMP was more susceptible against A. baumannii, the resistance rate was 14.6%. The resistance rate to AMP, CEC, CTX was all 100%. the susceptibility rate of S. aureus to VAN was 100% and its resistance rate to NIT and MEM was 16.7% and 11.1%, respectively. CONCLUSIONS The common strains from patients with mechanical ventilation in ICU are multiple-resistant to antibiotics, clinicians should be aware of the most common bacterial pathogens and their resistance patterns, once suspect to infection with mechanical ventilation, the selection of antimicrobial agents for the initial empiric treatment is important.
出处
《中华医院感染学杂志》
CAS
CSCD
2004年第11期1298-1301,共4页
Chinese Journal of Nosocomiology
关键词
ICU
机械通气
铜绿假单胞菌
鲍氏不动杆菌
ICU
Mechanical ventilation
Pseudomonas aeruginosa
Acinetobacter baumannii
