重症医学科内感染患者病原菌的分布及鲍曼不动杆菌耐药分析

目的探讨重症医学科(ICU)中感染的病原菌分布及鲍曼不动杆菌耐药情况。方法采用VITEK 2compact微生物鉴定系统进行细菌鉴定,最低抑菌浓度(MIC)法检测细菌药物敏感性及耐药性。结果 126例患者中98例至少有一个部位分离出病原菌,共分离出病原菌181株,分离的部位以下呼吸道为主。在181株分离的菌株中,G-杆菌125株,以非发酵菌为主,且鲍曼不动杆菌对亚胺培南、美罗培南的耐药率分别达85.29%、84.85%,其他抗菌药包括头孢三代、喹诺酮类、哌拉西林耐药率均>70%,仅有头孢哌酮/舒巴坦、妥布霉素、阿米卡星耐药率<30%。结论 ICU内感染的病原菌主要存在于呼吸道,病原菌以G-杆菌为主,鲍曼不动杆菌显示多重耐药,应加强ICU病原菌的管理与监测。

Distribute of Pathogens Bacteria and Drug Resistance of Acinetobacter Baumannii in Intensive Care Unit

Objective To investigate the distribution of pathogens and drug resistance of Acinetobacter baumannii in intensive care unit(ICU). Methods VITEK 2 compact system was applied for bacteria identification.The of MIC was used to detect pathogens′ drug sensitivity and resistance. Results Totally 181 strains of pathogens were isolated,at least one location in 98 among the 126 patients,and with the lower respiratory tract being the main site.Among the 181 strains,125 were Gram-negative bacteria,with non-fermenting bacteria accounting for the most.The drug resistances of Acinetobacter baumannii to Imipenem and Meropenem were 85.29% and 84.85% respectively.The drug resistance of other antibacterial drugs including the third generation Cephalosporin,Quinolones Piperacillin was more than 70%.Only the drug resistance rate of cefoperazone/sulbactam,tobramycin,and amikacin was lower than 30%. Conclusion The lower respiratory tract is the major infection site in ICU.Gram-negative bacteria is the most common strain of pathogens,and Acinetobacter baumannii presents with multi-drug resistance.So the management and monitoring work should be enhanced in ICU.