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目的分析某综合医院重症监护病房(ICU)病原菌分布及其耐药性,为有针对性采取预防措施,合理选用抗生素提供可靠依据。方法对2012年1-12月ICU分离的731株病原菌进行分布及耐药性分析。结果不同送检物中检测到的病原菌数量不同,其中痰液中检测到的菌株数最多,占66.89%,其次为肺泡灌洗液(8.34%)和血液(7.52%)。病原菌主要分布在61~90岁患者。在检测到的病原菌中,革兰阴性杆菌检出率最高,占52.67%;革兰阴性杆菌中铜绿假单胞菌检出率最高,其次为肺炎克雷伯菌和鲍曼不动杆菌;革兰阳性球菌中金黄色葡萄球菌检出率最高,其次为停乳链球菌和粪肠球菌;真菌中白色念珠菌检出率最高,其次为烟曲霉。5株革兰阴性杆菌和5株革兰阳性菌对临床常用抗菌药物,均出现较高的耐药性。结论 ICU病原菌感染以老年人多见,主要以呼吸系统感染为主,其中革兰阴性杆菌感染率较高,不同病原菌对抗生素的敏感性不同,因此临床工作中要对高危人群采取预防措施,并根据药敏结果合理应用抗菌药物。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in intensive care unit (ICU) of a general hospital and provide a reliable basis for taking targeted preventive measures and rational use of antibiotics. Methods The distribution and drug resistance of 731 isolates from January to December in ICU were analyzed. Results The number of pathogens detected in different samples was different. The number of bacteria detected in sputum was the highest (66.89%), followed by alveolar lavage fluid (8.34%) and blood (7.52%). Pathogenic bacteria are mainly distributed in patients aged 61 to 90 years. Among the tested pathogens, Gram-negative bacilli had the highest detection rate, accounting for 52.67%; Gram-negative bacilli had the highest detection rate of Pseudomonas aeruginosa, followed by Klebsiella pneumoniae and Acinetobacter baumannii; The positive rate of Staphylococcus aureus in Staphylococcus aureus was the highest, followed by Streptococcus dysgalactiae and Enterococcus faecalis; Candida albicans was the highest in fungi, followed by Aspergillus fumigatus. Five strains of Gram-negative bacilli and five strains of Gram-positive bacteria showed high resistance to common antibacterial drugs. Conclusion The pathogens of ICU are more common in the elderly, mainly in the respiratory system. Among them, the infection rate of Gram-negative bacilli is high, and the sensitivity of different pathogens to antibiotics is different. Therefore, precautionary measures should be taken in high-risk groups in clinical practice. According to the results of rational use of antimicrobial susceptibility drugs.