重症医学科下呼吸道感染病原菌分析及干预对策

【】 目的 研究重症医学科下呼吸道感染患者病原菌分布特点、耐药情况及干预措施。方法 分析2011年1月-2013年12月入住内蒙古医科大学附属医院重症医学科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348株,以革兰氏阴性杆菌为主,共225株占64.66%,其中鲍曼不动杆菌、大肠埃希菌和铜绿假单胞菌居多,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55.81%、44.74%,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93株,占26.72%,以金黄色葡萄球菌为主,对万古霉素、替考拉宁耐药为0；真菌30株占8.62%,白色念珠菌对常见抗真菌药耐药率为0,热带假丝酵母菌、光滑假丝酵母菌对氟康唑耐药率分别为60%和66.67%,对伏立康唑耐药率为0。结论 监测重症医学科患者下呼吸道感染病原菌种类及其耐药性的变化,对合理使用抗感染药物,制定干预对策有重要意义。

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 Analysis in January 2011 - December 2013 at Inner Mongolia medical university affiliated hospital patients with severe medicine were isolated from the sputum specimens of pathogenic bacteria, and the drug sensitive test, the disc diffusion method for pathogenic bacteria drug resistance analysis.Results 348 strains pathogenic bacteria isolated, mainly gram-negative bacilli, a total of 225 strains (64.66%), acinetobacter baumannii, Escherichia coli and pseudomonas aeruginosa, acinetobacter baumannii, pseudomonas aeruginosa to cefoperazone\sulbactam, low percentages, 55.81%, 44.74% respectively, Escherichia coli and Pneumonia Ke leibo bacteria were sensitive for Imipenem and Meroperem which drug resistance rate were zero; Gram positive coccus 93 strains, accounting for 26.72%, mainly on staphylococcus aureus,, their drug resistance rate to vancomycin and teicoplanin is 0; 30 strains (8.62%), fungus candida albicans to common antifungal drug resistant rate of 0, tropical candida, smooth candida to fluconazole resistant rate of 60% and 66.67% respectively, voriconazole resistant rate to zero.Conclusions There has significant for use antibiotics reasonably and improve the prognosis when we monitoring the category of pothogens and the drug resistance rate.