摘要
目的:了解我院近年重症监护病房(ICU)常见分离病原菌培养种类及分布特征,并分析耐药性变化趋势,为临床合理应用抗菌药物提供依据。方法:回顾性分析2019年1月-2023年12月荆门市中心医院综合ICU住院患者送检标本中培养的病原菌种类及耐药率,采用VITEK 2 COMPACT全自动微生物鉴定仪鉴定病原菌种类及进行药敏试验,数据采用WHONET5.6软件进行分析。结果:ICU共检出2361株非重复病原菌,其中革兰阴性菌占56.93%(以肺炎克雷伯菌为首),革兰阳性菌占17.62%(以金黄色葡萄球菌为主),真菌占25.46%(以白色念珠菌为主)。肠杆菌科细菌对替加环素、碳青霉烯类、氨基糖苷类药物耐药率均小于10%;鲍曼不动杆菌耐药率大于80%,仅对黏菌素、四环素类药物耐药率低;铜绿假单胞菌对常见抗菌药物耐药率均较低;葡萄球菌和肠球菌对大环内酯类与青霉素类药物耐药率大于70%。痰液与血液标本中病原菌检出率差异有统计学意义(P<0.05)。耐碳青霉烯类鲍曼不动杆菌检出率呈下降趋势(P<0.05)。结论:革兰阴性杆菌为ICU主要病原菌,以痰液标本检出为多。菌株的耐药性有上升趋势,以不动杆菌属和耐甲氧西林金黄色葡萄球菌感染为主,临床医生应在药敏试验结果指导下合理选用抗菌药物,以预防和减少耐药菌株的产生。
Objective To investigate the types,distribution and drug resistance of pathogenic bacteria in the intensive care unit(ICU)and to provide a basis for clinical treatment and rational drug use.Methods A retrospective analysis was con⁃ducted on the types of pathogenic bacteria cultured from specimens submitted by inpatients in the comprehensive ICU of Jingmen Central Hospital from January 2019 to December 2023,focusing on their drug resistance.The VITEK2 COMPACT system was employed to identify the types of pathogenic bacteria and perform drug susceptibility testing.Data were analyzed using WHONET 5.6.Results A total of 2,361 non-duplicated pathogenic bacteria were detected in the ICU,of which 56.93%were Gram-negative bacteria(primarily Klebsiella pneumoniae),17.62%were Gram-positive bacteria(primarily Staphylococcus aureus),and 25.46%were fungi(primarily Candida albicans).The resistance rate of Enterobacteriaceae to tigecycline,carbapenems,and aminoglycosides was less than 10%.The resistance rate of Acinetobacter baumannii was greater than 80%,with low resistance only to colistin and tetracyclines.Pseudomonas aeruginosa had low resistance to com⁃mon antimicrobial drugs.Staphylococcus and Enterococcus had resistance rates greater than 70%to macrolides and penicil⁃lins.There was a difference in the detection of pathogenic bacteria in sputum and blood samples(P<0.05).A decreasing trend was observed in the detection of carbapenem-resistant A.baumannii(P<0.05).Conclusion Gram-negative bacilli are the primary pathogens in the ICU,predominantly detected in sputum specimens.The drug resistance of these strains is on the rise,with Acinetobacter species and methicillin-resistant S.aureus being the main culprits.Clinicians should use an⁃timicrobial drugs judiciously based on antimicrobial susceptibility test results to prevent and reduce the emergence of resistant strains.
作者
田娟
徐金莲
TIAN Juan;XU Jin-lian(Department of Hospital Infection Control,Jingmen Central Hospital,Jingchu University of Technology,Jingmen,Hubei 448000,China;Department of Clinical Laboratory,Jingmen Central Hospital,Jingchu University of Technology,Jingmen,Hubei 448000,China)
出处
《湖北医药学院学报》
2025年第6期725-730,共6页
Journal of Hubei University of Medicine
关键词
重症监护病房
病原菌
检出率
耐药性
Intensive care unit(ICU)
Pathogenic bacteria
Detection rate
Drug resistance
