NSICU患者肺部感染病原菌分布及耐药情况分析

目的 探讨NSICU患者肺部感染的病原菌分布及耐药情况，为患者治疗方案提供指导。方法 选取本院2018年1月—2018年12月NSICU收治有肺部感染的患者450例，均取深部痰液，通过细菌分离鉴定技术、药物敏感性试验及耐药检测方法，对送检合格标本进行病原学检测和耐药性分析，使用扩散法对抗菌药物作药敏试验。结果 450名NSICU患者检测出538株病原菌，其中革兰阴性菌382株(71.00%)，其中肺炎克雷伯菌139株、鲍曼不动杆菌101株、大肠埃希菌65株、铜绿假单胞菌40株。肺炎克雷伯菌与大肠埃希菌对亚胺培南、头孢哌酮/舒巴坦、头孢吡肟的耐药性较低；鲍曼不动杆菌对头孢哌酮/舒巴坦的耐药性较低；铜绿假单胞菌对各种药物的耐药率均较低，不到25%。革兰阳性菌99株(18.40%)，包括金黄色葡萄球菌49株、凝固酶阴性葡萄球菌38株，对万古霉素、利奈唑胺、替加环素的耐药较低。真菌57株(10.60%)，其中热带假丝酵母23株、白假丝酵母20株、光滑假丝酵母14株。 结论

Analysis of distribution and drug resistance of pathogenic bacteria with lung infections patients in NSICU#br#

Objective To investigate the distribution and drug resistance of pathogenic bacteria in lung infections of patients with NSICU, and to provide guidance for patients’ treatment plan. Methods A total of 450 patients with pulmonary infections in our hospital from January 2018 to December 2018 were enrolled in NSICU. All of them took deep sputum and passed the bacterial isolation and identification technology, drug sensitivity test, and drug resistance test method. The pathogen detection and drug resistance analysis were conducted, and the diffusion method was used to test susceptibility to antibacterial drugs. Results 538 strains of pathogens were detected in 450 NSICU patients, including 382 Gram-negative bacteria (71.00%), including 139 strains of Klebsiella pneumoniae, 101 strains of Acinetobacter baumannii, 65 strains of Escherichia coli, and 40 strains of Pseudomonas aeruginosa. Klebsiella pneumoniae and Escherichia coli had low resistance to imipenem, cefoperazone-sulbactam, and cefepime. Resistance of cefoperazone/sulbactam to Acinetobacter baumannii was less. Pseudomonas aeruginosa had a low resistance rate (less than 25%) to various drugs. 99 Gram-positive bacteria (18.40%) included 49 strains of Staphylococcus aureus and 38 strains of coagulase-negative staphylococci, which were less resistant to vancomycin, linezolid, and tigecycline. 57 strains (10.60%) of fungi, including 23 Candida tropicalis, 20 Candida albicans, and 14 Candida glabrata. Conclusion By detecting the distribution of pathogens in the lung infections of patients with NSICU and the drug resistance of bacteria, it can provide guidance for clinical rational drug use and improve the therapeutic