ICU患者呼吸道感染病原菌及耐药性分析

An analysis of the pathogens of respiratory tract and drug resistance in Intensive Care Unit(ICU)patients

目的 :了解ICU患者呼吸道病原菌感染情况并对其耐药性进行分析 ,为治疗提供依据。方法 :对344例ICU患者痰标本进行分离培养 ,用VITEK 6 0型全自动细菌分析系统对病原菌进行鉴定和药敏试验。结果 :344例中阳性 2 6 5例 (占 77.0 % ) ;两种以上病原菌混合感染 (占 37.7% ) ;所分离病原菌中以G-菌为主(占 5 3.1% ) ,其次为G+菌 (占 2 5 .5 % )、真菌 (占 2 1.4% )。在G-菌中 ,以鲍曼氏不动杆菌为主 (占 2 9.8% ) ;G+菌以金黄色葡萄球菌为主 (占 6 0 .0 % ) ,所分离的葡萄球菌 β 内酰胺酶均呈阳性 ;真菌以白色念珠菌为主(占 5 2 .5 % )。在细菌耐药性方面 ,G-菌对舒普深、头孢他啶及亚胺培南的耐药率较低 ,分别为 4.3%、2 8.8%和 36 .9%。结论 :ICU患者呼吸道感染情况及细菌的耐药性严重 ,临床应根据实验室报告进行合理用药 ,对此类病人需加强护理 ,并进行必要的隔离。

Objective:To analyse the prevalence of nosocomial infection and the extent of drug resistance in respiratory tract infection patients in ICU.Methods:The pathogenic bacteria were isolated and cultured; identification and antibiotic susceptibility test were done by VITEK AMS.Results:Of 344 sputum samples, incubated microorganism was found existing in 256 cases(77.0%). More than two pathogens commix infection accounted for 37.7%. The most prevalent of pathogens was Gram negative bacteria(53.1%), then Gram positive bacteria(25.5%)and fungi(21.4%). In Gram negative bacteria Acinetobacter baumannii was the major one(29.8%)and in Gram positive bacteria Staphylococcus aureus(60.0%)was most prominent and the isolated Staphylococcus' beta lactamases were all positive. Candida albicans(52.5%)was the main type of fungi among all the isolated pathogens. The resistance rate of Gram negative bacteria to sulperaton?ceftazidime?emipenem was low, being 4.3%?28.8% and 36.9% respectively.Conclusion:The respiratory tract infection in ICU patients was as serious as the drug resistance of bacteria. Analysis of bacterial resistance profile is prerequisite to the proper use of antibiotics. Standard precautions and contact isolation are essential.