摘要
目的探讨ICU肺部感染的病原菌分布,分析药敏试验结果,为临床治疗提供依据。方法收集2011年1月-2012年11月ICU 68例肺部感染患者的痰液标本,采用VITEK微生物鉴定系统进行菌株鉴定,并采用K-B法进行药敏试验,对结果进行统计分析。结果 68份痰液标本中共分离出124株病原菌,其中革兰阴性菌84株占67.8%,革兰阳性菌21株占16.9%,真菌19株占15.3%;排名前5位病原菌依次为铜绿假单胞菌、肺炎克雷伯菌、金黄色葡萄球菌、嗜麦芽寡养单胞菌、白色假丝酵母菌,分别占27.4%、16.9%、12.9%、11.3%、11.3%;药敏试验显示,革兰阳性菌中金黄色葡萄球菌对青霉素G耐药率为100.0%;革兰阴性菌中铜绿假单胞菌对阿米卡星较为敏感,对其他抗菌药物的耐药性均较强,肺炎克雷伯菌对阿米卡星及环丙沙星的耐药性较强,真菌中白色假丝酵母菌对伊曲康唑、氟康唑有一定耐药性,对酮康唑、两性霉素B的敏感性最高,耐药率均为0。结论 ICU肺部感染的病原菌以革兰阴性菌为主,革兰阳性菌和革兰阴性菌对常用抗菌药物均产生了较严重的耐药性,应加强早期的病原菌检查,指导临床合理选择抗菌药物,提高治疗效果。
OBJECTIVE To explore the distribution of pathogenic bacteria causing pulmonary infections in ICU and analyze the result of drug susceptibility testing so as to guide the clinical treatment. METHODS The sputum specimens were collected from 68 patients with pulmonary infections who were treated in the ICU from Jan 2011 to Nov 2012, the VITEK microbiological assay system was used for the strain identification, and K-B was adopted for the drug susceptibility testing, and the result of the drug susceptibility testing was statistically significant. RESULTS Totally 124 strains of pathogenic bacteria were isolated from 68 sputum specimens, including 84 （67.8%） strains of gram-negative bacteria , 21 （16.9%） strains of gram-positive bacteria, and 19 （15.3%） strains of fungi. Pseudornonas aeruginosa, Klebsiella pneumoniae, Staphylococcus aureus, Stenotrophomonas aeromonas, and Candida albicans ranked the top five species of pathogens, accounting for 27. 4%, 16. 9%, 12.9%, 11.3%, and 11.3% , respectively. The drug susceptibility testing indicated that the drug resistance rate of the S. aureus to penicillin G was 100.0%, the P. aeruginosa was sensitive to amikacin and was highly resistant to other antibiotics, the K. pneumoniae was highly resistant to amikacin or ciprofloxacin, and the C. albicans was resistant to itraconazole or fluconazole and was the most sensitive to ketoconazole or amphotericin B with the drug resistance rate of 0%. CONCLUSION The gram-negative bacteria are the main pathogens causing pulmonary infections in the ICU, both the gram-positive bacteria and the gram-negative bacteria have produced high drug resistance to commonly used antibiotics. It is necessary to strengthen the detection of pathogens in early stage so as to guide the reasonable clinical use of antibiotics and improve the therapeutic effect.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第10期2472-2474,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
Resistance
