摘要
目的了解医院近2年重症监护病房(ICU)病原菌分布及其耐药情况。方法收集2007～2008年ICU送检的1013份标本,采用API鉴定系统进行菌株鉴定及药敏试验。结果共分离出562株病原菌,阳性率55.5%,革兰阴性菌构成比明显高于革兰阳性菌,最常见的革兰阴性菌分别是铜绿假单胞菌(21.0%)、鲍氏不动杆菌(16.7%)、大肠埃希菌(8.2%)、产酸克雷伯菌(7.1%)、肺炎克雷伯菌(6.0%)、嗜麦芽寡养单胞菌(5.2%)与阴沟肠杆菌(4.6%);在革兰阳性菌中以葡萄球菌属和肠球菌属为主;主要革兰阴性杆菌对头孢哌酮/舒巴坦均敏感,而对其他多数常用抗菌药物耐药,肠杆菌科中产ESBLs菌株对青霉素类和头孢类抗菌药物耐药率明显高于非产ESBLs菌株,葡萄球菌属对万古霉素、替考拉宁等敏感;耐甲氧西林葡萄球菌(MRS)对常用抗菌药物耐药性均高于对甲氧西林敏感葡萄球菌(MSS),肠球菌属对多数常用抗菌药物耐药,仅对万古霉素与喹奴普汀/达福普汀敏感。结论调查结果表明,ICU病原菌以革兰阴性菌为主,检出菌均存在严重耐药问题,及时监测病原菌变化及耐药趋势以指导临床用药至关重要。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria detected from intensive care units（ICU） during the last two years in our hospital.METHODS We collected 1013 samples from 2007 to 2008 from ICU in our hospital.The API system was used to identify the pathogenic bacteria and conduct antibiotic susceptibility test.RESULTS A total of 562 pathogenic bacteria were isolated from 1013 samples.The positive rate was 55.5%.Gram-negative bacteria remained more frequent than Gram-positive bacteria.The most common Gram-negative bacteria causing ICU infection were Pseudomonas aeruginosa（21.0% of the isolates）,followed by Acinetobacter baumannii（16.7% of the isolates）,Escherichia coli（8.2% of the isolates）,Klebsiella oxytoca（7.1% of the isolates）,K.peumoniae（6.0% of the isolates）,Stenotrophomomas maltophilia（5.2% of the isolates） and Enterococcus cloacae（4.6% of the isolates） among the isolates.The dominant Gram-positive pathogenic bacteria causing ICU infection were Staphylococcus and Enterococcus.The dominant Gram-negative pathogenic bacteria were sensitive to cefoperazone/sulbactam,and resistant against various other antibiotics.ESBLs producing strains were more resistant to penicillins and cephalosprins than ESBLs non producing strains.Staphylococcus were sensitive to vancomycin,teicoplanin,quinupristin/dalfopristin,nitrofurantoin,minocycline and fusidic acid.The drug resistance of meticillin-resistant Staphylococcus（MRS） were higher to commonly used antibiotics than meticillin-sensitive Streptococcus（MSS）.Enterococcus were comparatively sensitive to vancomycin and quinupristin/dalfopristin,and resistant against various other antibiotics.CONCLUSIONS The most pathogenic bacteria isolated from ICU are Gram-negative bacteria.Drug resistance of isolated pathogenic bacteria from ICU is a serious problem.Monitoring the change in pathogen and the trends of antimicrobial is very important in guiding the clinical administration of drugs.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2010年第6期887-889,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
病原菌
耐药性
Intensive care unit
Pathogenic bacteria
Drug resistance
