ICU患者痰细菌分布特征及药敏分析

Microbiological Characteristics of Sputum from ICU Patients

目的统计分析2009年1～11月佛山市中医院ICU痰标本细菌培养病原菌分布特征及药敏情况,为临床经验用药提供科学的参考。方法留取经镜检合格的痰标本,经分离培养出病原菌后,以法国梅里埃VITEK2全自动细菌鉴定分析仪鉴定,以K-B法检测药物敏感性,用MICROSOFT OFFICE Excel2003进行数据处理。结果共分离出288株菌,病原菌分布以铜绿假单胞菌最多占20%,其次是金黄色葡萄球菌、鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌,分别是14%、13%、10%、7%。药敏结果显示,铜绿假单胞菌和鲍曼不动杆菌对头孢吡肟、头孢他啶、亚胺培南、阿米卡星等的敏感率均达75%以上;阿米卡星、亚胺培南和头孢西丁对肺炎克雷伯菌与大肠埃希菌的抗菌活性也较好;金黄色葡萄球菌对万古霉素、替考拉宁、呋喃妥因等的敏感率较高,均为75%以上,而对青霉素仅有2%的敏感率。结论痰培养病原菌以铜绿假单胞菌和金黄色葡萄球菌为主;对于革兰阴性杆菌,可选用第三代头孢菌素、氨基糖苷类抗生素,对革兰阳性球菌,可用万古霉素、替考拉宁、呋喃妥因。

Objective To analyze the microbiological characteristics,especially the bacterial flora and their drug resistance,of sputum from the patients at Foshan TCM Hospital intensive care unit.Methods Sputum samples were initially microscopically-screened.Bacterial colonies were then isolated and identified using the French Merieux VITEK2 automatic bacteria identification apparatus.K-B method was used for the testing of drug sensitivity.Experimental results were then analyzed using MICROSOFT OFFICE Excel 2003.Results A total of 288 bacterial isolated were obtained.Pseudomonas aeruginosa was the most abundant species,accounting for 20%.Other species included Staphylococcus aureus（14%）,Acinetobacter baumannii（13%）,Klebsiella pneumoniae（10%）and Escherichia coli（7%）.Results from the susceptibility test showed that the sensitivity rate of Pseudomonas aeruginosa and Acinetobacter baumannii to cefepime,ceftazidime,imipenem and amikacin was over 75%.Amikacin and Imipenem South Cefoxitin were effective for Klebsiella pneumoniae and E.coli.Staphylococcus aureus was sensitive to vancomycin,teicoplanin and nitrofurantoin,with a sensitive of greater than 75%.However,the sensitivity rate to penicillin was only 2%.Conclusion Pseudomonas aeruginosa and Staphylococcus aureus were the major species in the bacterial isolates.The third-generation cephalosporin and aminoglycoside antibiotic can be used for the control of the Gram-negative bacteria.Vancomycin,Kauranen and nitrofurantoin can be sued for the control of Gram-positive cocci.