重症监护病房408例痰标本细菌培养和耐药性

目的了解重症监护病房(ICU)下呼吸道感染痰菌的分布和耐药性。方法对2004年1月~2005年11月重症监护病房患者的深部痰,进行细菌培养和抗菌药物试验进行回顾性分析。结果408例痰标本中216例检出细菌,阳性率为52.94%;216例阳性标本中检出细菌数为240株,革兰阴性菌172株,阳性率为71.7%,革兰阳性菌35株,阳性率为14.6%,真菌33株,阳性率为13.7%;以鲍氏不动杆菌占居首位;药敏结果显示,革兰阴性菌总耐药率最低的是头孢哌酮/舒巴坦为0,其次是亚胺培南(17.8%)、左氧氟沙星(20.0%);革兰阳性菌万古霉素最为敏感,葡萄球菌属对万古霉素未发现耐药菌株;念珠菌属药敏结果全部敏感。结论鲍氏不动杆菌分离率显著高于报道,耐药情况严重,显示监测细菌分布及耐药性变化的重要性。

Bacterial Culturing and Drug Resistance of 408 Phlegm Samples from ICU

OBJECTIVE To establish the distribution and the drug resistance of the pathogens of lower respiratory tract infections in a comprehensive intensive care unit(ICU).METHODS The bacterial culturing and the tests on the antibiotic from the deep phlegm in an ICU of the hospital from 2004 to 2005 were retrospectively analyzed.RESULTS Totally 408 phlegm samples were tested and 216 of them had bacteria,the positive rate was 52.94%.From them were isolated 240 strains of bacteria(among them 12 samples with 2 kinds of bacteria).The strains of Gram-negative bacteria were 172 and the positive rate was 71.7%,there were 35 strains of Gram-positive cocci with the positive rate of 14.6%.And there were 33 strains of fungi,the positive rate was 13.7%.Acinetobacter baumannii occupied the first place.The lowest drug resistance rate of the Gram-negatives was to SCF(0.0%),IMP(17.8%),and LEV((20.0%)).All Gram-positive cocci were sensitive to vancomycin,no vancomycin resistant.Staphylococcus were found.Candida albicans was sensitive to all tested drugs.CONCLUSIONS The isolation rate of A.baumannii is significant higher than reported before and its drug resistance is heavier.It indicated the importance of monitoring bacterial distribution and drug resistance dynamics.