刘晓兰.ICU重症感染患者革兰氏阴性菌的分布及药敏特点.[J].中南医学科学杂志.,2016,(4):457-459, 480.
ICU重症感染患者革兰氏阴性菌的分布及药敏特点
Distribution and Drug Sensitivity of Gram-NegativeBacteria in Intensive Care Unit Infection
投稿时间:2015-12-03  修订日期:2016-05-26
DOI:
中文关键词:  重症监护病房  重症感染  革兰氏阴性菌  耐药
英文关键词:intensive care units  severe infection  gram-negative bacteria  drug resistance
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作者单位
刘晓兰 青海省西宁市第二人民医院ICU,青海 西宁 810003 
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中文摘要:
      目的 探讨本院ICU重症感染患者革兰氏阴性菌(G-菌)的分布和药敏特点。方法取本院ICU重症感染的患者的各类送检标本290份,从标本中分离和培养G-菌,对G-菌的标本分布情况,各种G-菌的比例及排名前5位的菌种对常见抗菌药物的的耐药率进行比较和分析。结果290份标本中共分离320株G-菌,在痰液中分布最多,为214株(66.9%);所占比例排名前5位的G-菌依次为鲍曼不动杆菌(18.4%),铜绿假单胞菌(15.3%),大肠埃希菌(14.4%),肺炎克雷伯菌(11.9%),阴沟肠杆菌(10.3%);鲍曼不动杆菌耐药的主要抗菌药物(及耐药率)为氨苄西林/舒巴坦(74.6%)、头孢曲松(67.8%)和头孢噻肟(49.2%);铜绿假单胞菌耐药的主要抗菌药物(及耐药率)为氨苄西林/舒巴坦(81.6%)、哌拉西林/他唑巴坦(69.4%)、头孢曲松(55.1%)、头孢噻肟(53.1%)和环丙沙星(55.1%);大肠埃希菌的主要抗菌药物(及耐药率)为氨苄西林/舒巴坦(50.0%)、头孢噻肟(47.8%)和环丙沙星(50.0%);肺炎克雷伯菌的主要抗菌药物(及耐药率)为氨苄西林/舒巴坦(73.7%)、环丙沙星(44.7%)和左氧氟沙星(78.9%);阴沟肠杆菌的主要抗菌药物(及耐药率)为氨苄西林/舒巴坦(81.8%)、头孢曲松(63.6%)、头孢噻肟(66.7%)和环丙沙星(60.6%)。结论ICU重症感染患者G-菌种类多样、分布广泛、耐药性强,且许多菌株具有多重耐药性。故ICU科室中应该严格规范无菌操作,定期消毒和灭菌,规范和控制抗生素的使用,从而有效预防ICU患者感染的发生。
英文摘要:
      Objective To explore the distribution and drug sensitivity of gram-negative bacteria(G-) in intensive care unit(ICU) infection in our hospital.MethodThe G- bacteria was isolated from 290 cases of clinical specimens from ICU,and then cultured and analyzed the distribution and drug sensitivity of main G- bacteria.Results320 strains of G- bacteria were isolated from 290 cases of clinical specimens,among which the most strains were isolated from sputum,accounting for 66.9%.The G- bacteria in top five strains were as follows:acinetobacter baumannii (18.4%),pseudomonas aeruginosa(15.3%),escherichia coli(14.4%),klebsiella pneumonia(11.9%)and enterobacter cloacae(10.3%).The main antibacterial drugs and resistance rates of acinetobacter baumannii were ampicillin/sulbactam(74.6%),ceftriaxone(67.8%) and cefotaxime(49.2%).The main antibacterial drugs and resistance rates of pseudomonas aeruginosa were ampicillin/sulbactam(81.6%),piperacillin/tazobactam(69.4%),ceftriaxone(55.1%),cefotaxime(53.1%)and ciprofloxacin(55.1%);The main antibacterial drugs and resistance rates of Escherichia coli were ampicillin/sulbactam(50.0%),cefotaxime(47.8%)and Ciprofloxacin(50.0%);The main antibacterial drugs and resistance rates of klebsiella pneumonia were ampicillin/sulbactam(73.7%),ciprofloxacin(44.7%)and levofloxacin(78.9%);The main antibacterial drugs and resistance rates of enterobacter cloacae were ampicillin/sulbactam(81.8%),ceftriaxone(63.6%)、cefotaxime(66.7%)and ciprofloxacin(60.6%).ConclusionG- bacteria in ICU infection are various,widely distributed and highly drug-resistant.Many strains have multiple drug tolerance.Therefore,strict aseptic technique,criterion inerrant operation,sterilization and disinfection at regular intervals and regulate and control the use of antibiotics are in great requirement to diminish the risk of infection.
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