ICU革兰阴性杆菌耐药性监测及治疗策略

目的 监测医院ICU革兰阴性杆菌的耐药性,为临床合理应用抗菌药物、合理制定用药方案提供依据.方法 从临床送检标本中分离出病原菌,用全自动细菌鉴定及药敏测定仪进行耐药性监测.结果 革兰阴性杆菌检出数量分别为大肠埃希菌产ESBLs菌175株、铜绿假单胞菌169例、肺炎克雷伯菌非产ESBLs菌115株、大肠埃希菌非产ESBLs菌103株、鲍氏不动杆菌83株、肺炎克雷伯菌产ESBLs菌75株、嗜麦芽寡养单胞菌22株.结论 对ICU革兰阴性杆菌耐药性监测,掌握常见细菌耐药特点,对合理使用抗菌药物非常重要.

Surveillance for antimicrobial resistance of gram-negative bacilli in ICU and strategies for treatment

OBJECTIVE To monitor the resistance of gram-negative bacilli in ICU and provide basis for the reasonable use of antibiotics and the development of drug program.METHODS The pathogens were isolated from clinical specimens,the surveillance for drug resistance was performed by using automatic bacterial identification system and drug susceptibility testing system.RESULTS Of all the gram-negative bacilli isolated,there were 175 strains of ESBLs producing E.coli,169 strains of P.aeruginosa,115 strains of non-ESBLs producing K.pneumoniae isolates,103 strains of non-ESBLs producing E.coli,83 strains of A.baumannii,75 strains of ESBLs producing K.pneumoniae,and 22 strains of Stenotrophomonas maltophihia.CONCLUSION To perform the surveillance for the drug resistance of gram-negative bacilli in ICU and grasp the characteristics of bacterial resistance is very important for the reasonable use of antibiotics.