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目的:探讨重症监护室多重耐药菌的耐药情况。方法:对2015年9月至2017年2月期间新疆喀什地区第一人民医院重症监护室收治的40例发生院内感染患者的临床资料进行回顾性研究。对这40例患者进行多重耐药菌检测,然后观察其多重耐药菌的种类和耐药情况。结果:1)在这40例患者中,共检测出87株耐药菌。其中,有鲍曼不动杆菌28株,占32.18%;有洋葱伯克霍尔杆菌8株,占9.19%;有肺炎克雷伯杆菌14株,占16.09%,有嗜麦寡养单胞菌10株,占11.49%;有铜绿假单胞菌22株,占25.29%;有金黄色葡萄球菌5株,占5.75%。其中,鲍曼不动杆菌的检出率最高,与其他耐药菌的检出率相比差异有统计学意义(P<0.05)。2)在这87株多重耐药菌中,28株鲍曼不动杆菌对头孢西丁的耐药率为100%,对多粘菌素E的耐药率为17.86%;8株洋葱伯克霍尔杆菌对呋喃妥因的耐药率为100%,对头孢噻肟的耐药率为12.5%;14株肺炎克雷伯杆菌对庆大霉素的耐药率为78.57%,对亚胺培南的耐药率为21.43%;10株嗜麦寡养单胞菌对氨苄西林的耐药率为80%,对头孢哌酮的耐药率为10%;22株铜绿假单胞菌对庆大霉素的耐药率为81.82%,对头孢唑林的耐药率为27.27%;5株金黄色葡萄球菌对青霉素的耐药率为100%,对万古霉素的耐药率为20%。结论:重症监护室的多重耐药菌主要为有鲍曼不动杆菌、洋葱伯克霍尔杆菌、肺炎克雷伯杆菌、嗜麦寡养单胞菌、铜绿假单胞菌和金黄色葡萄球菌。其中,鲍曼不动杆菌对头孢西丁的耐药性较高,洋葱伯克霍尔杆菌对呋喃妥因的耐药性较高,肺炎克雷伯杆菌对庆大霉素的耐药性较高,嗜麦寡养单胞菌对氨苄西林的耐药性较高,铜绿假单胞菌对庆大霉素的耐药性较高,金黄色葡萄球菌对青霉素的耐药性较高。
Objective: To investigate the drug resistance of multidrug-resistant bacteria in intensive care unit. Methods: The clinical data of 40 patients with nosocomial infection admitted to the First People’s Hospital of Kashi Prefecture in Xinjiang from September 2015 to February 2017 were retrospectively reviewed. The 40 patients were tested for multi-resistant bacteria, and then observed the type of multi-resistant bacteria and drug resistance. Results: 1) Of the 40 patients, 87 resistant bacteria were detected. Among them, 28 strains of Acinetobacter baumannii accounted for 32.18%, 8 strains of Burkholderia cepacia (9.19%), 14 strains of Klebsiella pneumoniae (16.09%), Stenotrophomonas maltophilia 10 strains, accounting for 11.49%; 22 strains of Pseudomonas aeruginosa, accounting for 25.29%; 5 strains of Staphylococcus aureus, accounting for 5.75%. Among them, Acinetobacter baumannii had the highest detection rate, which was significantly different from other resistant bacteria (P <0.05). 2) Among the 87 multidrug-resistant strains, 28 strains of Acinetobacter baumannii had a resistance rate of 100% to cefoxitin and 17.86% to polymyxin E. Eight onion Burk The resistant rate of Huperzan to nitrofurantoin was 100% and the resistance rate to cefotaxime was 12.5%. The resistance rates of 14 strains of Klebsiella pneumoniae to gentamycin were 78.57% Resistant rate was 21.43%. The resistance rate of 10 strains of Stenotrophomonas maltophilia to ampicillin was 80% and the rate of resistance to cefoperazone was 10%. 22 strains of Pseudomonas aeruginosa to Qingda The rate of resistance to cefazolin was 81.82% and the rate of resistance to cefazolin was 27.27%. The resistance rate of five strains of S. aureus to penicillin was 100% and the rate to vancomycin was 20%. Conclusion: The multidrug-resistant bacteria in intensive care unit mainly include Acinetobacter baumannii, Burkholderia cepacia, Klebsiella pneumoniae, Stenotrophomonas maltophilia, Pseudomonas aeruginosa and Staphylococcus aureus . Among them, Acinetobacter baumannii was more resistant to cefoxitin, Burkholderia cepacia was more resistant to nitrofurantoin, Klebsiella pneumoniae was more resistant to gentamicin, Stenotrophomonas maltophilia was more resistant to ampicillin, Pseudomonas aeruginosa higher resistance to gentamicin, Staphylococcus aureus higher resistance to penicillin.