ICU内中心静脉导管相关性血流感染病原菌分布及耐药性分析

Distribution of Pathogenic Bacteria and Drug Resistance of Central Venous Catheter Related Bloodstream Infection in ICU

目的观察和分析ICU内中心静脉导管相关性血流感染病原菌的分布以及耐药性情况。方法回顾性分析我院2010年1月至2015年6月住院期间110例ICU导管相关性血流感染患者使用中心静脉导管的试验资料,比较排位靠前的5例细菌的耐药性特征,分析感染细菌的种类以及分布情况。结果 110例ICU导管相关性血流感染患者当中共检出140株病原菌;其中革兰阴性菌55株,占39.29%;革兰阳性菌85株,占60.71%;引起导管相关性血流感染的病原主要包括鲍氏不动杆菌、大肠埃希菌、表皮葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌,分别占菌株总数的20.52%、13.25%、14.58%、22.21%、23.21%;鲍氏不动杆菌与大肠埃希菌的耐药率为80.00%,表皮葡萄球菌的耐药率为77.5%,明显高于金黄色葡萄球65.2%的耐药率,P<0.05。结论近2年ICU内中心静脉导管相关性血流感染病原菌中,革兰阳性菌的数量明显多于革兰阴性菌,通过耐药性比对可知,革兰阴性菌的耐药率明显高于革兰阳性菌,主要病原菌的耐药率平均为60.00%。因此,在我国今后的ICU内中心静脉导管相关性血流感染病原菌临床治疗过程中,未获得药敏结果前的经验性用药应当兼顾革兰阴性菌与革兰阳性菌。

Objective This study aimed to observe and analyze the distribution of pathogenic bacteria and drug resistance of the central venous catheter related bloodstream infection in ICU.Methods A total of 110 cases of ICU catheter related bloodstream infection in our hospital from June 2015 to January 2010,were followed up retrospectively.The data of 5cases of bacterial drug resistance characteristics using central venous catheter was compared,and the type and distribution of infected bacteria were analysed.Results Among 110 cases of ICU catheter related bloodstream infection,140 strains of pathogenic bacteria were detected,in which 55 strains of gram negative bacteria and 85 gram positive bacteria accounting for 39.29% and 60.71% respectively.Conclusion In the past 2years,the number of gram positive bacteria was significantly higher than that of gram negative bacteria in the central venous catheter related bloodstream infection in ICU.Therefore,the clinical treatment process of the central venous catheter related bloodstream infection in ICU should be considered gram negative bacteria and gram positive bacteria when it not being obtained drug sensitivity results before the empirical medication.