摘要
目的 调查重症监护病房 (ICU )医院内肺炎 (NP)菌群的分布及耐药特点 ,探讨其临床防治对策。方法 回顾总结 ICU 1998年 7月～ 2 0 0 0年 7月 NP的病原菌谱、耐药性及其临床特征。结果 131例 NP感染菌 389株中 G- 杆菌占 6 5 .6 %、G+ 球菌占 2 3.1%、真菌占 11.3% ;G- 杆菌以铜绿假单胞菌为主 (43.1% ) ,G+ 球菌主要为金黄色葡萄球菌 (90 .0 % ) ,MRSA占金黄色葡萄菌的 96 .3% ;产 ESBL菌主要为肺炎克雷伯菌和大肠埃希菌 ;除嗜麦芽黄单胞菌外 ,G- 杆菌对亚胺培南 /西司他丁、阿米卡星、哌拉西林 /三唑巴坦、头孢他啶较敏感 ;产 ESBL菌株对亚胺培南 /西司他丁、MRSA对万古霉素皆有 10 0 %的敏感率。结论 NP感染以 G- 杆菌为主对亚胺培南 /西司他丁敏感 ,为降低多重耐药菌和产 ESBL菌的产生 ,对人工通气管道应定时彻底消毒 ,并严格控制第三代头孢菌素的使用。
OBJECTIVE To investigate the bacterial spectrum of nosocomial pneumonia(NP) and characteristics of drug resistance in ICU and to evaluate the clinical preventive and therapeutic countermeasures.METHODS The bacterial spectrum from ICU and its drug resistance and the clinical characteristics were retrospectively analysed during July 1998 July 2000. RESULTS In 389 strains isolated from 131 cases with NP, the percentage of G - bacillus, Gram positive bacteria and fungi were 65.6%, 23.1% and 11.3%, respectively.In G - bacteria Pseudomonas aeruginosa strains were the major ones (43.1%) and in G + cocci Staphylococcus aureus(SA) was the most prominent(90%) and MRSA was 96.3% in SA. The bacteria producing ESBL were mainly from E.coli and K.pneumoniae. Except Xanthomonas maltophilia strains, imipenem, amikacin, piperacillin/tazobactam, ceftazidim were relatively active against the G - bacillus. The sensitive rate of ESBL producing strains to imipenem and MRSA to vancomycin are all 100%. CONCLUSIONS [HT5”,6SS]It was shown that the most prevalent isolates of pathogens of NP were G - bacteria which were the most susceptible to imipenem. In order to decrease the incidence of some multidrug resistant organisms and producing ESBL bacteria, it is very important to sterilize thoroughly and timely artificial ventilative tubes and control rigorously a lasting use of 3rd generation cephalosporins.
出处
《中华医院感染学杂志》
CAS
CSCD
2002年第5期329-331,共3页
Chinese Journal of Nosocomiology
