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目的分析重症监护病房(ICU)感染患者中非发酵菌的分布及耐药性,为临床抗感染治疗提供依据。方法选取2013年6月-2015年6月ICU住院患者200例作为研究对象,采集患者的各类标本并对其中的非发酵菌进行菌种鉴定和药敏试验。结果在各类标本中,共分离出非发酵菌253株,其中,痰液和引流液中的非发酵菌构成比最高,分别占47.4%和12.3%;在分离出的非发酵菌中,以铜绿假单胞菌、鲍氏不动杆菌、嗜麦芽寡养单胞菌的构成比最高,分别占38.7%、28.1%和22.9%;分离出的主要非发酵菌对于常用抗菌药物具有较高的耐药率,铜绿假单胞菌对阿米卡星、妥布霉素、头孢哌酮/舒巴坦较敏感,耐药率<25.0%,鲍氏不动杆菌对头孢哌酮/舒巴坦、阿米卡星、米诺环素较敏感,耐药率<43.0%,嗜麦芽寡养单胞菌对米诺环素、头孢哌酮/舒巴坦、左氧氟沙星较敏感,耐药率<28.0%。结论 ICU住院患者中非发酵菌的分布和耐药性具有一定的特征,临床医师应准确识别,及时监控其变化趋势,选取敏感抗菌药物进行抗感染治疗,从而达到提高治疗效果、改善患者预后的目的。
Objective To analyze the distribution and drug resistance of non-fermentative bacteria in patients with intensive care unit (ICU) infection and provide basis for clinical anti-infective therapy. Methods A total of 200 ICU inpatients from June 2013 to June 2015 were selected as research objects. All samples of patients were collected and their non-fermentative bacteria were identified and susceptible to antibiotics. Results A total of 253 strains of non-fermenting bacteria were isolated from all kinds of specimens. Among them, the highest proportion of non-fermentative bacteria was found in sputum and drainage fluid, accounting for 47.4% and 12.3% respectively. Among the isolated non-fermentative bacteria, Pseudomonas aeruginosa, Acinetobacter baumannii and Stenotrophomonas maltophilia were the highest, accounting for 38.7%, 28.1% and 22.9% respectively. The main non-fermenting bacteria isolated had higher Resistance rate of Pseudomonas aeruginosa to amikacin, tobramycin, cefoperazone / sulbactam more sensitive rate was <25.0%, Acinetobacter baumannii cefoperazone / sulbactam , Amikacin and minocycline were more sensitive, the resistance rate was <43.0%. Stenotrophomonas maltophilia was more sensitive to minocycline, cefoperazone / sulbactam and levofloxacin, and the resistance rate was less than 28.0 %. Conclusion The distribution and drug resistance of non-fermentative bacteria in hospitalized patients with ICU have certain characteristics. Clinicians should accurately identify and monitor their changes in time and select antimicrobial drugs for anti-infective treatment so as to improve the therapeutic effect and improve the prognosis of patients purpose.