摘要
目的：监测医院感染主要病原菌的耐药性，分析IC U抗菌药物的临床使用情况，为临床合理用药提供依据。方法对医院2012年3月－2013年7月IC U临床分离的主要病原菌耐药性和同期抗菌药物用药频度进行统计分析。结果2012年3月－2013年7月ICU抗菌药物的使用频度（DDDs）排序前10位依次为阿米卡星、左氧氟沙星、头孢替安、奥硝唑、头孢地嗪、氟康唑、头孢哌酮／舒巴坦、亚胺培南、头孢呋辛钠和万古霉素；分离出病原菌159株，以革兰阴性杆菌为主121株占76．10％，其次真菌24株占15．09％和革兰阳性球菌占8．81％；肠杆菌科细菌对亚胺培南敏感率为100．00％，对哌拉西林／他唑巴坦、头孢哌酮／他唑巴坦等β‐内酰胺酶抑制剂类药物和阿米卡星有较好的敏感性；铜绿假单胞菌是 ICU分离出最多的病原菌，耐药严重，耐药率为45．83％-93．75％；鲍氏不动杆菌仅对头孢哌酮／他唑巴坦敏感率较好为77．78％；革兰阳性球菌对万古霉素敏感率100．00％，对青霉素类和头孢类耐药严重。结论医院IC U常见病原菌以革兰阴性杆菌为主，对多种抗菌药物的耐药率较高，呈现多药耐药严重，阿米卡星、左氧氟沙星和头孢类抗菌药物是IC U临床使用频度高的药物。
OBJECTIVE To investigate the drug resistance of the major species of pathogens causing nosocomial in‐fections and analyze the clinical use of antibiotics in ICUs so as to provide guidance for reasonable clinical use of an‐tibiotics .METHODS The major clinical isolates of pathogens were isolated from the ICUs from Mar 2012 to Jul 2013 ,then the drug resistance of the pathogens and the DDDs were statistically analyzed .RESULTS The top ten DDDs of antibiotics that were used in the ICUs from Mar 2012 to Jul 2013 were as follows ：amikacin ,levofloxa‐cin ,cefotiam ,ornidazole ,cefodizime ,fluconazole ,cefoperazone‐sulbactam ,imipenem ,cefuroxime sodium ,and vancomycin .A total of 159 strains of pathogens have been isolated ,including 121 （76 .10% ） strains of gram‐nega‐tive bacilli ,24 （15 .09% ） strains of fungi ,and the gram‐positive cocci （8 .81% ） .The drug susceptibility rate of the Enterobacteriaceae isolates to imipenem was 100 .00% ,and the strains were highly susceptible to β‐lactamases inhibitors such as piperacillin‐tazobactam and cefoperazone‐tazobactam as well as amikacin . The Pseudomonas aeruginosa isolates were dominant among the pathogens isolated from the ICUs and were highly drug‐resistant , with the drug resistance rate ranging from 45 .83% to 93 .75% .The drug susceptibility rate of the Acinetobacter baumannii isolates to cefoperazone‐tazobactam was 77 .78% .The drug susceptibility rate of the gram‐positive coc‐ci to vancomycin was 100 .00% , and the strains were highly resistant to penicillins and cephalosporins . CONCLUSION The gram‐negative bacilli are the most common pathogens isolated from the ICUs and are highly re‐sistant to a variety of antibiotics ,showing serious multidrug‐resistance .Amikacin ,levofloxacin ,and cephalospo‐rins are the most frequently used antibiotics in the ICUs .
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2015年第5期1064-1066,共3页
Chinese Journal of Nosocomiology
基金
北京教委中医药与护理研究专项基金资助项目(12ZYH03)
关键词
重症监护病房
用药频度
耐药性
合理使用
Intensive care unit
Defined daily dose
Drug resistance
Reasonable use
