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目的分析医院ICU入住患者的菌群分布和耐药性,为临床治疗提供依据。方法选择2013-2014年入住医院ICU病原菌培养结果阳性患者3 688例,用BACTEC FX全自动细菌培养系统和VITEK-2Compact全自动细菌鉴定仪进行菌株鉴定及药敏分析,将病原菌的分布及药敏结果进行分析。结果 3 688例患者标本中以痰液标本最多,占53.38%;其次为血液及脓汁,分别占15.55%及5.27%;共分离出病原菌3 688株,其中革兰阴性菌占64.30%,革兰阳性球菌株占23.44%,真菌占11.27%;主要革兰阳性菌对青霉素G、红霉素、四环素的耐药率均>60.0%,鲍氏不动杆菌对头孢吡肟、亚胺培南和环丙沙星的耐药率均>90.0%。结论医院ICU患者感染病原菌仍以革兰阴性菌为主,但耐药率有上升趋势,革兰阴性菌中以鲍氏不动杆菌为主,真菌感染有下降趋势,应加强ICU主要致病菌及其耐药性监测,合理使用抗菌药物,减少医院感染及耐药菌产生。
Objective To analyze the distribution and drug resistance of the patients admitted to the hospital ICU and provide the basis for clinical treatment. Methods A total of 3 688 patients with positive ICU pathogens were selected in hospital from 2013 to 2014. The strains were identified by BACTEC FX automatic bacterial culture system and VITEK-2 Compact automatic bacterial analyzer. The distribution and drug sensitivity of pathogens Results were analyzed. Results Among 3 688 samples, sputum specimens accounted for 53.38%, followed by blood and pus, accounting for 15.55% and 5.27% respectively. A total of 3 688 pathogens were isolated, of which Gram-negative bacteria accounted for 64.30% Staphylococcus aureus strains accounted for 23.44% and fungi accounted for 11.27%. The resistance rates of major gram-positive bacteria to penicillin G, erythromycin and tetracycline were both> 60.0%. Acinetobacter baumannii did not inhibit cefepime, imipenem And ciprofloxacin resistance rates were> 90.0%. Conclusions The main pathogenic bacteria in hospital ICU patients are still Gram-negative bacteria, but the drug resistance rate is on the rise. Gram-negative bacteria mainly include Acinetobacter baumannii, and the fungal infections have a decreasing trend. The major pathogens of ICU should be strengthened And drug resistance monitoring, rational use of antimicrobial agents, reduce hospital infection and drug-resistant bacteria.