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目的观察基层医院重症监护病房住院患者感染病原菌特点及其耐药情况。方法选择基层医院ICU住院的496例的病原资料,观察其感染率、病原菌分布及耐药性。结果基层医院ICU医院感染发生率为20.97%,以脑卒中30.80%)和多发伤(18.95%)为主,下呼吸道感染(31.73%)和泌尿系统感染(27.88%)居高。医院感染病原菌以革兰阴性菌(61.90%)为主,革兰阳性菌(30.95%)偏低。革兰阴性菌以大肠埃希菌(16.67%)最多,其次依次为铜绿假单胞菌、克雷伯菌属、鲍曼不动杆菌、阴沟肠杆菌。药敏试验显示革兰阴性菌对含酶抑制剂类的亚胺培南耐药率低,而头孢呋辛、头孢他啶、头孢曲松等耐药率高。革兰阳性菌主要以金黄色葡萄球菌(16.07%)为主,其次为溶血性链球菌、肠球菌等。药敏试验显示革兰阳性菌对万古霉素、替考拉宁、利奈唑胺敏感,未发现对万古霉素、替考拉宁、利奈唑胺耐药菌株。结论降低院内感染发生率必须加强医院感染相关因素的控制和预防。
Objective To observe the characteristics and drug resistance of pathogenic bacteria in hospitalized patients in intensive care unit of primary hospital. Methods The pathogenic data of 496 hospitalized patients in ICU of primary hospital were selected and the infection rate, pathogen distribution and drug resistance were observed. Results The prevalence of nosocomial infections in ICU was 20.97% in primary hospitals, 30.80% in stroke patients and 18.95% in multiple injuries. The lower respiratory tract infections (31.73%) and urinary tract infections (27.88%) were high. Gram-negative bacteria (61.90%) were the main pathogens in hospital and Gram-positive bacteria (30.95%) were low. Gram-negative bacteria were Escherichia coli (16.67%), followed by Pseudomonas aeruginosa, Klebsiella, Acinetobacter baumannii, Enterobacter cloacae. Susceptibility tests showed that gram-negative bacteria resistant to imipenem-containing inhibitors, while cefuroxime, ceftazidime, ceftriaxone and other high resistance rates. Gram-positive bacteria mainly Staphylococcus aureus (16.07%), followed by hemolytic streptococcus, enterococci and so on. Susceptibility tests showed that Gram-positive bacteria were sensitive to vancomycin, teicoplanin and linezolid, and vancomycin, teicoplanin and linezolid were not found. Conclusion To reduce the incidence of nosocomial infection, we must strengthen the control and prevention of nosocomial infection related factors.