重症监护病房下呼吸道病原菌的菌群分布及其药敏分析

The distribution and drug resistance analysis of pathogenic bacteria isolated from lower respiratory track in Intensive Care Unit

目的了解重症监护病房(ICU)患者下呼吸道病原菌的菌群分布及药敏情况,为临床应用抗生素提供依据。方法对该院2004年10月至2007年9月369例院内肺部感染者取深部痰液进行培养和药物敏感试验。结果共检出383株病原菌,其中G-杆菌331株,占86.4%;G+球菌21株,占5.5%;真菌31株,占8.1%。居前两位病原菌是肺炎克雷伯菌122株,铜绿假单胞菌81株。药物敏感试验显示,亚胺培南和丁胺卡那霉素对肺炎克雷伯菌的敏感率最高,分别为100.0%和86.1%;万古霉素对葡萄球菌敏感率最高,达100.0%。结论肺炎克雷伯菌和铜绿假单胞菌是该院ICU的主要病原菌,应合理选用抗生素,减少耐药菌株的产生。

Objective This study investigated the pathogen distribution and resistance patterns in ICU patients with lower respiratory tract infection.in order to provide references for optimal use of antibiotics in the treatment. Methods Sputum specimens for bacterial cultures were collected in sterile tubes from 369 patients with LRTI in ICU who had been admitted between 2004.10 and 2007.9. Anti- biotic susceptibility tests were tested after bacteria were identified. Results 383 strains were bacteria- positive, Gram-negative bacilli was predominant pathogenic bacteria（331 strains）, accounting for 86. 6% of the cases. Gram-positive cocci （21 strains） accounted for 5%. Fungi was rarely seen（3l strains） , accounting for only 8.1 %. Klebsiella pneumoniae （K. pneumoniae） （122 strains） was the most common , followedby Pseudornonas Aeruginosa （A. Pseduonornaus） （81 strains）. Antibiotic susceptibility tests showed that K. pneumoniae had a highest sensitive rate to IMP（100 %） and AMK （86.1%）, Staphylococcus had a highest sensitive rate to vancomycin（100%）. Conclusion K. pneu- moniae and Pseudornonas Aeruginosa were common pathogens of LRTI in ICU. Antibiotics for trea- ting LRTI should be selected based on the drug susceptibility test to avoid drug-resistant strains.