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孙悦波, 汪艳. 重症监护病房革兰阴性杆菌耐药监测分析[J]. 中国公共卫生, 2009, 25(5): 616-618. DOI: 10.11847/zgggws2009-25-05-58
引用本文: 孙悦波, 汪艳. 重症监护病房革兰阴性杆菌耐药监测分析[J]. 中国公共卫生, 2009, 25(5): 616-618. DOI: 10.11847/zgggws2009-25-05-58
SUN Yue-bo, WANG Yan. Monitoring on drug resistance of Gram-negative bacilli in ICU ward[J]. Chinese Journal of Public Health, 2009, 25(5): 616-618. DOI: 10.11847/zgggws2009-25-05-58
Citation: SUN Yue-bo, WANG Yan. Monitoring on drug resistance of Gram-negative bacilli in ICU ward[J]. Chinese Journal of Public Health, 2009, 25(5): 616-618. DOI: 10.11847/zgggws2009-25-05-58

重症监护病房革兰阴性杆菌耐药监测分析

Monitoring on drug resistance of Gram-negative bacilli in ICU ward

  • 摘要: 目的了解重症监护病房(ICU)革兰阴性杆菌的分离率及耐药谱,为合理使用抗生素及院内感染监控提供依据。方法采用自动细菌鉴定仪(ATB-expression)进行细菌鉴定,Kirby-Bauer纸片法进行药敏试验;用WHONET5.4软件统计分析病原菌分离率及耐药率。结果ICU分离革兰阴性杆菌677株,其中铜绿假单胞菌占39.0%,鲍氏不动杆菌占17.0%,肺炎克雷伯菌占16.8%,嗜麦芽寡养单胞菌占11.4%,大肠埃希菌占4.3%。677株分离株中,产超广谱β-内酰胺酶(ESBLS)肺炎克雷伯菌占56.1%;产超广谱β-内酰胺酶(ESBLS)大肠埃希菌占24.1%。非发酵菌504株,占74.5%,耐药率较低抗生素有:头胞吡肟49.3%,美罗培南50.4%,哌拉西林/他唑巴坦51.8%,头胞他啶57.9%;发酵菌173株,占25.5%;发酵菌耐药率较低的抗生素有美罗培南0%,哌拉西林/他唑巴坦34.5%,丁胺卡钠45.3%,头胞吡肟54.3%,头胞他啶61.3%。结论重症监护病房革兰阴性杆菌感染中,非发酵菌占优势,铜绿假单胞菌分离率最高。

     

    Abstract: ObjectiveTo learn the isolation rate and the profile of drug resistance of Gram-negative bacilli in ICU ward in order to provide the basis for rational administration of antibacterial and infection prevention.MethodsIdentification of bacteria was performed by ATB-expression system and the drug sensitivity test was conducted with Kirby-Bauer method.The detection rate and drug resistant rate were analyzed with WHONET 5.4 software.ResultsTotally 677 strains of Gram-negative bacilli were isolated from various clinical specimens in ICU ward from 2005 to 2007.The predominant pathogens were Pseudomonas aerations(3910%),Acinetobacter Baumann(17.0%),Klebsiella pneumonia(16.8%), Stenotrophomonas Maltophilia(11.4%),Escherichia coli(4.3%).Among them,56.3% Klebsiella pneumonia strains produced ESBLs,24.1% of Escherichia coli produced ESBLs.504(74.5%)strains of non-fermented were isolated.The antibiotic resiance of non-fermented strains to Caffeine,Meropenem,Piperacilli, Tazobacyam and Ceftazidmie was 49.3%,50.4%, 51.8% and 57.9%,respectively.The resistant rate of fermenter straines to Reopened,Piperacillin/Tazobac tam,Amice,Caffeine and Ceftazidime was 0%,34.5%,45.3%,54.3% and 61.3%,respectively.ConclusionGram-negative bacilli are main pathogen in ICU ward,non-fermented are predominant patho gen,and the detection rate of Pseudomnas are the highest.

     

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