摘要
目的了解重症医学科下呼吸道医院感染病原菌的分布及其耐药性,为指导临床科室尤其是重症医学科下呼吸道医院感染控制提供依据。方法回顾性分析ICU住院患者痰标本细菌培养及药敏结果,对采集的合格痰标本采用VTTEK-2Compact全自动细菌分析仪进行细菌鉴定,采用K-B纸片法进行药敏试验,按CLSI 2010年的标准判断。结果共555株病原菌中革兰阴性菌、革兰阳性菌、真菌分别占67.6%、18.7%、13.7%;革兰阴性菌中以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌、褪色沙雷菌多见,分别占17.3%、11.9%、10.3%、6.1%;革兰阳性菌以金黄色葡萄球菌为主,占8.6%;真菌以白色假丝酵母菌为主,占10.5%;主要革兰阴性菌呈多药耐药或泛耐药,主要革兰阳性菌多为MRSA或MRSCN;革兰阳性球菌对万古霉素、喹奴普汀/达福普汀、替考拉宁及夫西地酸耐药率较低。结论 ICU住院患者下呼吸道医院感染的病原菌以非发酵菌、肠杆菌科细菌、MRSA及MRSCN多见,且菌株耐药现象严重,应加强对ICU患者下呼吸道医院感染病原菌分布及耐药性的监测。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria causing lower respiratory tract infections in intensive care unit （ ICU）, and provide evidence for the control of lower respiratory tract infections in the clinical departments,especially the ICU. METHODS The results of the bacterial culture of sputum specimens and the drug susceptibility testing were analyzed retrospectively VTTEK-2 Compacl automatic bacteria analyzer was employed to identify the bacteria isolated from the qualified sputum specimens, and the dray susceptibility teslng was performed by K-B methoclg, the result was judged accorcling to CLSI 2010. RESULTS A total of 555 strains of pathogenic bacteria were isolated, including the gram-negative bacteria （67. 6%）, gram- positive bacteria（18. 7%）, and fungi （13. 7 %）. Among the gram-negative bacteria, Pseudomonas aeruginosa, Acinetobacter baumanii, Klebsiella pneumonia ,and Serratia marcescens were the most common, accounting for 17.3%, 11.9%, 10.o%, and 6.1% respeetivelyl Staphylococcus aureus was dominant in the gram-positive bac- teria, accounting for 8.6%. Candida albicans was the main species of fungi, accounting for 10.5%. The majority of the gram-negative bacteria were multi-drug resistant or pandrug-resistant, and MRNCSA and MRSA were the common species of the gram-positive bacteria. The drug resistance rates of the gram-positive cocci to vancomycin, teicoplanin, quinupristin-dalfopristin, and fusidic acid were relatively low. CONCLUSION The non-fermenting bacteria, Enterobacteriaceae, MRNCSA, and MRSA are the most common species of pathogens causing lower respiratory tract infections in the hospitalized patient in ICU and are highly drug resistant. It is necessary to intensify the monitoring of the distribution and drug resistance of the pathogens causing lower respiratory tract infections in ICU patients.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第23期5402-5404,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
医院感染
病原菌
耐药性
下呼吸道感染
Intensive care unit
Nosocomiai infection
Pathogenic bacteria
Drug resistance
Lower respiratory tract infection
