ICU痰培养阳性标本的病原菌分布及耐药性分析

Distribution and resistance analysis of pathogen of positive specimens cultured from ICU sputum

目的了解本院重症监护病房ICU痰培养阳性标本细菌分布及耐药情况,为临床治疗提供依据。方法总结2010年-2013年本院重症监护病房ICU患者送检的痰培养阳性标本,采用梅里埃公司VITEK 2-COMPACT全自动细菌分析仪进行细菌的鉴定及药敏试验。结果分离病原菌1 595株,其中革兰阴性菌最常见的是鲍曼不动杆菌446株,占总分离菌的28.0%;其次为洋葱伯克霍尔德菌180株,占总分离菌的11.3%。在革兰阳性菌中以金黄色葡萄球菌为主,有115株,占总分离菌的7.2%;真菌以曲霉菌为主,有45株,占总分离菌的2.8%。鲍曼不动杆菌对常用抗生素的耐药率较高,多重耐药;金黄色葡萄球菌对青霉素类、氟喹诺酮类、大环内酯类有较高的耐药率,而对于万古霉素、替考拉宁敏感。结论 ICU呼吸道感染病原菌的菌群分布以革兰阴性菌为主,多重耐药菌增多,临床医师需密切关注分离菌的变迁及耐药情况,合理使用抗菌药物,以减少耐药菌株的产生和播散。

Objective To investigate the distribution and drug resistance of positive specimens cultured from ICU sputum, so as to provide basis for the clinical treatment. Methods Sputum cultures specimens from ICU in our hospital from 2010 to 2013 were tested, and identification and drug sensitivity test were conducted using VITEK 2 - COMPACT auto bacteria analyzer. Results 1 595 pathogen strains were isolated, the most common of Gram - negative bacteria was Acinetobacter baumannii（446） , accounted for 28.0% in total isolates; The followed one was Burkholderia cepacia（180） , accounted for 11.3% in total isolates; In Gram - positive bacteria Staphylococcus aureus were based ones （ 115 ） , accounted for 7.2% in total isolates ; And in Aspergillus Fungi dominated（45 ） , accounted for 2.8% in total isolates. Acinetobacter baurnannii had higher resistance rates to commonly used antibiotics with multi - drug resistance; Staphylococcus aureus had a higher resistance rates to penicillins, fluoroquinolones, macrolides, and was sensitive to forvaneomycin and teieoplanin. Conclusion Distribution of respiratory tract infection pathogens was based on Gram - negative bacteria in ICU, and multi - drug resistant bacteria increased, clinicians should pay close attention to the changes and resistance of pathogenic bacteria and use antibiotics rationally to reduce the generation and spread of resistant strains.