ICU血流感染病原菌特征及混合血流感染的危险因素分析

Analyze the Pathogenic Bacteria Characteristics of ICU Bloodstream Infection and Risk Factors of Mixed Bloodstream Infection

目的为有效减少ICU患者血流感染,临床对感染致病菌分布、种类等情况以及感染后危险因素进行分析。方法方便选取并回顾性分析该院2013年5月—2016年3月期间收治的96例ICU血液感染患者,入院后对所有患者进行抽取静脉血并行病菌培养、细菌鉴定,探究其耐药性,同时对预后危险因素进行分析。结果菌种分布情况其中多数菌种分布情况肠球菌14.3%、鲍氏不动杆菌17.3%、大肠埃希菌10.2%、洋葱伯克霍尔德菌12.2%,铜绿假单胞菌、金黄色葡萄球菌、肺炎克雷白菌菌种分布较少;头孢哌酮、阿米卡星对多数革兰阴性菌种敏感性较高,庆大霉素、对多数阴性菌种有较高耐药性,环丙沙星对大肠埃希菌耐药性较高;庆大霉素、环丙沙星、青霉素对革兰阳性菌种有较高耐药性,万古霉素对阳性菌种敏感性较高;性别、年龄、脑血管疾病、肾功能不全、侵入操作、糖尿病史均是引发疾病发生的危险因素。结论致病菌多数为鲍氏不动杆菌、肠球菌,且对于有糖尿病史、脑血管疾病、肾功能不全、年纪较大、男性患者,发病率较高。

Objective To effectively reduce the bloodstream infection rate for ICU patients, analyze the distribution, types and risk factors of pathogenic bacteria. Methods Convenient selection 96 ICU patients with bloodstream infection treated from May 2013 to March 2016 in our hospital were selected. The venous blood was collected; the bacteria was cultured and identified to explore its drug resistance and risk factors. Results The major bacteria included enterococcus（14.3%）, acinetobacter baumannii（17.3%）, escherichia coli（10.2%） and burkholderia cepacia（12.2%）. The pseudomonas aeruginosa, staphylococcus aureus and klebsiella pneumoniae was rarely seen. The gram-negative bacteria had a higher sensitivity on Cefoperazone and Amikacin;the negative bacteria had a higher drug resistance on Gentamicin; Escherichia coli had a higher drug resistance on Ciprofloxacin; the gram-positive bacteria had a higher drug resistance on Gentamicin, Ciprofloxacin and Penicillin; the positive bacteria had a higher sensitivity on Vancomycin; the risk factors included the patient＇s gender, age,cerebrovascular disease, renal insufficiency, invasive procedure, history of diabetes. Conclusion The major pathogenic bacteria includes acinetobacter baumannii and enterococcus;the risk factors of bloodstream infection include history of diabetes, cerebrovascular disease, renal insufficiency, older age and male patients.