摘要
目的了解重症监护室(ICU)患者常见的呼吸道病原菌和耐药现状,指导临床用药。方法回顾性分析2011年1～12月深圳市人民医院ICU分离的233株呼吸道病原菌的分布及耐药情况。结果革兰阴性(G-)菌73.39%,真菌15.88%,革兰阳性(G+)菌10.73%。鲍曼不动杆菌(AB)占G-菌60.82%。金黄色葡萄球菌占G+菌88.00%,其中耐甲氧西林金黄色葡萄球菌(MRSA)占其59.09%,白色假丝酵母菌占真菌72.97%。常见G-菌中,AB多药耐药现象严重,对米诺环素及头孢哌酮/舒巴坦耐药率最低。未发现耐万古霉素、替考拉宁和利奈唑胺的G+菌。发现耐伊曲康唑的光滑假丝酵母菌及热带假丝酵母菌各一株,耐氟康唑及伊曲康唑的克柔假丝酵母菌一株。结论 ICU呼吸道病原菌以G-菌为主,G-菌中AB分离率最高,存在多药耐药现象,米诺环素及头孢哌酮/舒巴坦可作为治疗的选择,对于其他的G-菌感染,碳青霉烯类药物及加酶抑制剂的抗生素可作为治疗的选择。真菌、MRSA感染亦不容忽视,应合理选择抗生素。
【Objective】 To review the common pathogen and drug-resistant condition in airway in ICU,so as to guide the treatment.【Methods】 Respectively analysis 233 strain pathogen from airways in ICU of Shenzhen People＇s Hospital from Jan to Dec,2011.【Results】 Gran negative bacteria accounted for 73.39%,fungi accounted for 15.88%,and Gran positive bacteria for 10.73%.Acinetobacter baumannii（AB） accounted for 60.82% of Gran negative bacteria.Staphylococcus aureus accounted for 88% of Gran negative,among which Methicillin-resistant Staphylococcus aureus（MRSA） accounted for 59.09%.Candida albicans accounted for 72.97% of fungi.AB was common in drug-resistant,but the resistant rate to minocycline and cefoperazone/Sulbactam was the lowest.Gran positive bacteria was not discovered to resistant to vancomycin,teicoplanin,and linezolid.One strain of candida glabrata and candida tropicalis were discovered to resistant to Itraconazole respectively.One strain of candida krusei was resistant Fluconazole and Itraconazole.【Conclusions】 Gran negative bacteria was the main pathogen in ICU,among which AB was the most common detected Gran negative bacteria and multiple drug-resistant.Minocycline and cefoperazone/Sulbactam could be an alternative for AB.For other Gran negative bacteria,carbapenems and enzyme inhibitors could be chosen.Fungi and MRSA could not be negative.Antibiotics should be chosen rationally.
出处
《中国现代医学杂志》
CAS
CSCD
北大核心
2012年第26期99-102,共4页
China Journal of Modern Medicine
