【摘要】：目的分析ICU住院患者感染病原菌分布及耐藥性,為抗菌藥物的合理應(yīng)用提供依據(jù)。方法選取2013年1月-2016年5月醫(yī)院ICU住院的72例感染患者,進(jìn)行細(xì)菌分離及鑒定,并分析感染患者的病原菌分布及藥敏試驗(yàn)結(jié)果。結(jié)果 ICU住院的72例感染患者的感染部位以呼吸道、泌尿道、消化道為主,分別占56.9%、26.4%和15.3%,標(biāo)本來(lái)源以痰液、尿液、血液為主,分別占52.7%、27.5%和18.7%;共分離病原菌91株,其中革蘭陰性菌55株占60.4%,革蘭陽(yáng)性菌34株占37.4%,真菌2株占2.2%;革蘭陰性菌中大腸埃希菌和肺炎克雷伯菌檢出率較高,分別為30.8%和16.5%,革蘭陽(yáng)性菌中腸球菌屬和金黃色葡萄球菌檢出率較高,分別為22.0%和9.9%,真菌中白假絲酵母菌占2.2%;革蘭陰性菌對(duì)氨基糖苷類、喹諾酮類、第三代頭孢菌素等抗菌藥物耐藥率較高,部分可達(dá)100.0%,而對(duì)美羅培南、亞胺培南、阿米卡星及頭孢哌酮/舒巴坦等仍較敏感,革蘭陽(yáng)性菌對(duì)青霉素、克林霉素等普遍耐藥,但對(duì)萬(wàn)古霉素、替考拉寧、利福平等仍較敏感。結(jié)論 ICU住院患者發(fā)生感染以呼吸道感染最為常見,泌尿系感染次之;在分離菌株中仍以革蘭陰性菌為主,對(duì)美羅培南、亞胺培南、阿米卡星及頭孢哌酮/舒巴坦等抗菌藥物仍較敏感,可以為臨床醫(yī)師的經(jīng)驗(yàn)性用藥提供依據(jù)。
[Abstract]:Objective to analyze the distribution and drug resistance of pathogenic bacteria in ICU inpatients so as to provide evidence for the rational use of antibiotics. Methods from January 2013 to May 2016, 72 patients with ICU infection were selected for bacterial isolation and identification. The distribution of pathogenic bacteria and the results of drug sensitivity test were analyzed. Results the main infection sites were respiratory tract, urinary tract and digestive tract, accounting for 56.9%, 26.4% and 15.3%, respectively. The main source of ICU infection was sputum, urine and blood, accounting for 52.7%, respectively. 27.5% and 18.7%; A total of 91 strains of pathogenic bacteria were isolated, of which 55 were Gram-negative bacteria (60.4%), 34 were Gram-positive bacteria (37.4%) and 2 were fungi (2.2%). The positive rates of Escherichia coli and Klebsiella pneumoniae in gram-negative bacteria were 30.8% and 16.5%, respectively. The detection rates of Enterococcus and Staphylococcus aureus in gram-positive bacteria were 22.0% and 9.9%, respectively, and the positive rates of Escherichia coli and Klebsiella pneumoniae in gram-negative bacteria were 30.8% and 16.5%, respectively. Candida albicans accounted for 2.2% of the fungi. Gram-negative bacteria were highly resistant to aminoglycosides, quinolones and third-generation cephalosporins, some of which were 100.0%, but were still sensitive to meropenem, imipenem, amikacin and cefoperazone / sulbactam. Gram-positive bacteria were generally resistant to penicillin and clindamycin, but were still sensitive to vancomycin, teicoplanin and rifampicin. Conclusion Respiratory tract infection is the most common infection in inpatients with ICU, followed by urinary tract infection. Gram-negative bacteria were still dominant in isolated strains. They were still sensitive to meropenem, imipenem, amikacin and cefoperazone / sulbactam.
【作者單位】： 東陽(yáng)市橫店集團(tuán)醫(yī)院ICU;東陽(yáng)市橫店集團(tuán)醫(yī)院檢驗(yàn)科;
【分類號(hào)】：R459.7

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