摘要
目的了解2009-2011年医院ICU患者菌群分布情况及其耐药性,以指导ICU合理用药。方法收集2009年1月-2011年12月入住医院ICU病原菌培养阳性患者2510例,用VITEK-2Compact全自动细菌检定仪或API鉴定系统进行菌株鉴定及药敏分析,对致病菌株的分布构成及药敏结果进行分析。结果共分离出病原菌2510株,其中革兰阴性杆菌1553株占61.87%,革兰阳性球菌434株占17.29%,真菌523株占20.84%;前4位病原菌依次为鲍氏不动杆菌、金黄色葡萄球菌、肺炎克雷伯菌、白色假丝酵母菌,分别占16.73%、12.31%、10.60%、10.60%;菌株来源以痰液为主,1487株占59.2%,其次为血液标本,246株占9.8%;主要革兰阳性球菌对常用抗菌药物耐药率普遍较高,但对氯霉素较敏感,未发现对利奈唑胺、万古霉素、替考拉宁耐药菌株,除大肠埃希菌对美罗培南、哌拉西林/他唑巴坦100.0%敏感外,主要革兰阴性杆菌对常用抗菌药物均产生了较严重的耐药性。结论近3年ICU感染仍以革兰阴性菌为主,但耐药率有上升趋势,其中鲍氏不动杆菌耐药现象严重,真菌感染有上升趋势,动态监测ICU病原菌分布和耐药性变化具有重要意义。
OBJECTIVE To understand the distribution of bacterial species in the ICU between 2009 and 2011 and analyze the drug resistance so as to guide the reasonable use of antibiotics. METHODS Totally 2510 cases of patients with pathogens cultured positive, who were hospitalized the ICU from Jan 2009 to Dec 2011, were enrolled in the study, then the identification of the bacterial isolates and the drug susceptibility testing were performed by using the VITEK-2 Compact full automatic bacterial identification instrument or API system, and the constituent ratio of the pathogenic bacteria and the result of drug susceptibility testing were analyzed. RESULTS A total of 2510 strains of pathogens were isolated, including 1553 （61.87 % ） strains of gram-negative bacilli, 434 （ 17.29 % ） strains of gram-positive cocci, and 523 （20.84%） strains of fungi; the Acinetobacter baumannii ,Staphylococcus aureus,Klebsiella pneumonia, and Candida albicans ranked the top four species of pathogens, accounting for 16.73%, 12.31%, 10.60%, and 10.60%, respectively. There were 1487 （59.2%） strains isolated from the sputum and 246 （9.8%） strains isolated from the blood specimens. The gram-positive cocci were highly resistant to the commonly used antibiotics and were sensitive to chloromycetin, and no strains resistant to linezolid, vancomycin, or teicoplanin were found; the main gram-negative bacilli were highly resistant to the commonly used antibiotics except that the Escherichia coli was 100.0% sensitive to meropenem and piperacillin-tazobactam. CONCLUSION The gram-negative bacteria are the predominant pathogens causing the infections in ICU during the past three years, the drug resistance rate shows an upward trend, the A. baumannii is highly resistant% the cases with fungal infections are increased. It is of great significance to dynamically monitor the distribution of pathogens in ICU and the change of drug resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第18期4524-4526,共3页
Chinese Journal of Nosocomiology
基金
黑龙江省青年科学基金项目(QC2012C014)
黑龙江省教育厅科学技术研究项目(12521214)
关键词
重症监护病房
病原菌
耐药性
Intensive care unit
Pathogenic bacteria
Drug resistance
