ICU患者血培养病原菌分布及耐药性分析

Distribution and drug resistance of blood culture pathogens in ICU patients

目的了解ICU患者血培养病原菌分布及其常见病原菌对抗菌药物的耐药性,为临床合理用药提供参考。方法收集来自ICU患者血培养分离的病原菌758株,用VITEK-32全自动微生物分析仪进行菌种鉴定,用K-B法进行药敏试验。结果共分离出758株病原菌,其中革兰阴性菌462株占60.95%,前3位分别为大肠埃希菌174株,占22.96%,肺炎克雷伯菌120株,占15.83%,铜绿假单胞菌60株,占7.92%;革兰阳性菌247株占32.59%,前3位分别为凝固酶阴性葡萄球菌151株,占19.92%,金黄色葡萄球菌59株,占7.78%,肠球菌属21株,占2.77%;真菌49株占6.46%;亚胺培南对革兰阴性菌最敏感,替考拉宁和万古霉素对革兰阳性菌最敏感。结论做好ICU患者血培养病原菌敏感性监测,根据药敏结果用药对于临床治疗有重要意义。

OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from ICU blood culture, so as to provide reference for the clinical rational use of antibiotics. METHODS A total of 758 strains of pathogens isolated from ICU were collected, those pathogens were identified by VITEK32 system, the drug susceptibility testing was performedby K-B method. RESULTS A total of 758 pathogens were isolated, including 462 （60.95%） strains gram-negative bacteria, 247（32. 59%） strains of gram-positive bacteria, and 49 （6.46%） strains of fungi. The top three species of the gram-negative bacteria were Escherichia coli （174 strains,22.96%）, Klebsiella pneumoniae （120 strains, 15.83 %）, and Pseudomonas aeruginosa （60 strains, 7.92 %）, the top three species of the gram-positive bacteria were coagulase-negative Staphylococci （151 strains, 19.92 %）, Staphylococ-cus aureus （ 59 strains, 7.78%） ,and Enterococci （ 21 strains, 2.77%）. The drug susceptibility testing showed that the gram-negative bacteria were most susceptible to imipenem, and the gram-positive bacteria were most susceptible to teicoplanin and vancomycin. CONCLUSION It is of great significance in the clinical treatment to use antibiotics on the basis of drug susceptibility testing and perform the monitoring of the drug susceptibility of the blood culture pathogens in ICU patients.