呼吸重症监护病房肺部感染的病原菌分布及其耐药性

目的了解呼吸重症监护病房(RICU)最常见的肺部感染痰菌的分布及耐药性. 方法对207例RICU肺部感染患者280次阳性痰培养结果及药物敏感试验进行分析. 结果 G 菌77株,占27.5%;其中金黄色葡萄球菌62株占22.1%,耐甲氧西林金黄色葡萄球菌(MRSA)53株占18.9%;G-菌162株,占57.9%,占前4位者分别为铜绿假单胞菌56株(20%),嗜麦芽寡养单胞菌25株(8.9%),肺炎克雷伯菌17株(6.1%),鲍氏不动杆菌14株(5%);真菌41株,占14.6%;其中以白色念珠菌为主,占10.7%;药物敏感试验显示铜绿假单胞菌对抗生素多重耐药率较高,嗜麦芽寡养单胞菌对环丙沙星耐药率较低,肺炎克雷伯菌和鲍氏不动杆菌仍然对碳青酶烯类敏感. 结论该组RICU肺部感染以G-杆菌为主;其中铜绿假单胞菌、嗜麦芽寡养单胞菌、肺炎克雷伯菌和鲍氏不动杆菌构成主要G-感染菌株;MRSA和真菌感染的比例较高.

Pathogens Distribution in Pulmonary Infection and Their Antibiotic Resistance in RICU

OBJECTIVE To comprehend the main pathogens from sputum in the most common pulmonary infections and their drug resistance in RICU. METHODS We studied 207 pulmonary infections cases in RICU and analyzed the result of cultured positive sputum for 280 times and conducted drug sensitive test. RESULTS The resultshowed that 77 G + bacteria strains made up 27.5%, with 62 Staphylococcus aureus strains taking up 22.1%, from which 53 strains of MRSA (18.9%); 162 G - bacteria strains made up 57.9%. The top four were, Pseudomonas aeruginosa (56 strains, 20%), Stenotrophomonas maltophilia (25 strains, 8.9%), Klebsiella pneumoniae (17 strains, 6.1%), and Acinetobacter baumanii (14 strains, 5%). Fungi were 41 strains (14.6%), with Candida albicans (10.7%) taking up the main part. The result of drug sensitive test showed the multiple drug fast rate of P. aeruginosa was comparatively high, S. maltophiliato ciprofloxacin was low, K. pneumoniae and A. baumanii were still sensitive to carbapenems. CONCLUSIONSG -bacilli play a main role in the pulmonary infection of these RICU cases. P. aeruginosa, S. maltophilia , K. pneumoniae, and A. baumanii are the chief G - pathogens of pulmonary infection. The proportion between MRSA and fungal infection is increasing.