ICU下呼吸道医院感染细菌耐药性监测结果分析

目的 了解重症监护病房(ICU)患者下呼吸道感染病原菌分布特点及耐药情况.方法 分析入住我院ICU患者送检的痰标本中分离出的病原菌,并用纸片扩散法进行药物敏感试验,进行病原菌耐药性分析.结果 分离出病原菌144株,以革兰氏阴性杆菌为主,共95株占65.97%,其中鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌和肺炎克雷伯菌为主,鲍曼不动杆菌、铜绿假单胞菌对头孢哌酮/舒巴坦耐药率较低,分别为64.71%、42.86%,大肠埃希菌和肺炎克雷伯菌对亚胺培南、美罗培南均敏感,耐药率为0;革兰氏阳性球菌41株,占28.47%,以金黄色葡萄球菌为主,真菌8株占5.56%,白色念珠菌对常见抗真菌药耐药率为0,克柔假丝酵母菌对氟康唑耐药率为100%.结论 监测ICU患者下呼吸道感染病原菌种类及其耐药性的变化,可合理使用抗菌药物.

Analysis of drug resistance in patients with lower respiratory tract infection in ICU

Objective To investigate pathogen distribution and drug resistance in patients with lower respiratory tract infection in the intensive care unit(ICU).Methods From January 2010 to January 2011,144 pathogens were isolated from sputum in patients with lower respiratory tract infection of ICU,and then the drug resistance test was determined by agar disc diffusion method and all results were analysised.Results 144 pathogens were isolated,and pathogenic Gram-negative bacilli was still dominated,accounted for 95(65.97%).The first four Gram-negative bacilli were Acinetobacter baumannii,Pseudomnnas aeruginsa,Escherichia coli and Pneumonia Ke leibo bacteria.The drug resistance rates of Acinetobacter baumannii and Pseudomnnas aeruginsa for cefoperazone/sulbactam were respectively 64.71% and 42.86%.Escherichia coli and Pneumonia Ke leibo bacteria were sensitive for Imipenem and Meroperem,and their drug resistance rates were zero;Gram-positive cocci accounted for 41(28.47%),in which Staphylococcus aureus was dominant and the drug resistance rate for Vancomycin were zero;fungal accounted for 8(5.56%) of the total composition,Candida alicans was sensitive for all common anti-fungi drug,and the drug resistance rate of Candida krusei for flconazole was 100%,but for Voriconazole was zero.Conclusions Monitoring the category of pothogens and the drug resistance rate in patients with lower respiratory tract infection in the ICU can have significant effects on reasonabl antibiotics use and improve the prognosis.