重症监护病房耐药菌的监测与用药分析

Monitoring and Drug Use of Drug-resistant Bacteria in Intensive Care Unit

目的:研究重症监护病房(ICU)中耐药菌的监测情况与用药。方法:选取2016年7月-2019年7月笔者所在医院收治的58例ICU患者为研究对象,对脓液、脑脊液等标本实施药敏试验与细菌鉴定,分析耐药菌来源、分布及耐药情况。结果:58份送检标本中检出140株病原菌,其中120株为革兰阴性菌,占比为85.71%;20株为革兰阳性菌,占比为14.29%。大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌均对头孢类抗生素及氨苄西林的耐药性较强,对丁胺卡那霉素的敏感性较高,均对替加环素无耐药性。结论:对ICU实施细菌耐药监测,有助于抗生素的合理使用及减少耐药菌感染率,需要引起重视。

Objective: To study the monitoring and drug analysis of drug-resistant bacteria in intensive care unit(ICU). Method: A total of 58 patients with ICU admitted to our hospital from July 2008 to July 2019 were enrolled in the study. The drug sensitivity test and bacterial identification were performed on the specimens of pus and cerebrospinal fluid, and the source, distribution and drug resistance of the drug-resistant bacteria were analyzed. Result: A total of 140 pathogenic bacteria were detected in 58 samples, of which 120 strains were Gram-negative bacilli, accounting for 85.71%, and 20 strains were Gram-positive bacilli, accounting for 14.29%. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii were all highly resistant to Cephalosporin antibiotics and Ampicillin, and the sensitivity to Amikacin was higher, but all had no resistance to Tigacycline. Conclusion: The monitoring of bacterial resistance in ICU is helpful for the rational use of antibiotics and reducing the infection rate of drug-resistant bacteria, so it needs to be paid attention to.