摘要
目的了解我院重症医学科病房常见病原菌的分布及其耐药性,为临床诊断及合理应用抗菌药物提供依据。方法收集2016年9月-2018年8月重症医学科病房患者送检的各类标本,采用VITEK2-compact全自动细菌鉴定仪对所有细菌进行鉴定及药敏试验,按照美国临床实验室标准化研究所(CLSI2018)标准判断病菌耐药性,并对药敏结果进行统计分析。结果3157份重症医学科病房患者标本中分离出病原菌746例,阳性率23.63%,非重复病原菌458例。其中革兰氏阴性菌占72.71%,革兰氏阳性菌占15.72%,真菌占11.57%,以白色假丝酵母菌为主。革兰氏阴性菌中,鲍曼不动杆菌检出率最高,为37.12%,其次为大肠埃希菌12.66%,铜绿假单胞菌9.61%。鲍曼不动杆菌及铜绿假单胞菌对常见抗菌药物呈多重耐药性,产超广谱β-内酰胺酶(Extended Spectrum Beta-Lactamases,ESBLs)大肠埃希菌的发生率为65.45%,产ESBLs肺炎克雷伯菌的发生率为51.58%,耐甲氧西林金黄色葡萄球菌(Methicillin-resistant Staphylococcus aureus,MRS A)发生率为70.59%。结论重症医学科病原菌呈多重耐药性,病原菌以革兰氏阴性菌为主。为此应加强对常见病原菌耐药监测,为临床合理用药,减少院内感染提供依据。
Objective To investigate the distribution and drug resistance of pathogenic bacteria in Intensive Care Unit(ICU) ward.Methods 3157 specimens from cases in ICU during the period from September,2016 to August,2018 were collected;VITEK2-compact automatic bacteria analyzer was applied in the identification and drug resistance testing of the pathogenic bacteria and American Clinical Laboratory Standardization(CLSI2018) was adopted to evaluate the drug resistance;the results were statistically analyzed.Results 458 pathogenic strains were isolated from746 specimens(detection rate:23.63%);among all the pathogenic bacteria,Gram-negative bacteria accounted for72.71%,Gram-positive bacteria 15.72% and fungi(mainly candida albicans) 11.57%;detection rate of acinetobacter baumannii(37.12%) was the highest in Gram-negative bacteria,followed by Escherichia coli(12.66%)and pseudomonas aeruginosa(9.61%);acinetobacter baumannii and pseudomonas aeruginosa were resistant to multiple common antibacterial agents;65.45% of Escherichia coli and 51.58% of Klebsiella pneumoniae produced extended spectrum beta-lactamases(ESBL);70.59% of Staphylococcus aureus was methicillin-resistant.ConclusionsPathogenic bacteria in ICU have multiple drug resistance and most of these bacteria are Gram-negative bacteria;drug resistance monitoring of these common pathogenic bacteria should be strengthened in clinical practice so as to provide reference for rational use of drugs and reduction of nosocomial infection.
作者
许竹生
刘媛
唐璐
谭积善
Xu Zhusheng;Liu Yuan;Tang Lu;Tan Jishan(Clinical laboratory,People's Hospital of Dazliu County,Dazhou City,Sichuan Province,635100,P.R.China;Clinical lalnjialorv,the General Hospital of Western Tlieater Coniniand,Chengdu,Sichuan Province,610083,P.R.China)
出处
《西南军医》
2019年第6期511-514,共4页
Journal of Military Surgeon in Southwest China
关键词
重症监护病房
病原菌
耐药性
多重耐药菌
intensive care unit
pathogenic bacteria
drug resistance
multi-drug resistant bacteria
作者简介
通信作者:谭积善,电子信箱:94153682@qq.com。
