关于急诊重症监护室病原微生物感染特点及细菌耐药性分析

Analysis of Pathogenic Microorganism Infection Characteristics and Bacterial Drug Resistance in Emergency Intensive Care Unit

目的探析急诊重症监护室(EICU)病原微生物感染特点、细菌耐药性情况。方法方便选取2018年1—12月该院EICU收治的486例患者,对其合并感染者进行标本病原学检验、药学敏感试验,以分析其病原微生物感染特点及细菌耐药性情况。结果486例患者的检测标本以痰液(71.16%)、血液(18.62%)为主,病原学检测阳性率为20.59%(272/1321);革兰阴性菌占55.00%(132/240)、革兰阳性菌为17.92%(43/240)、真菌白色假丝酵母菌为27.08%(65/240)。大肠埃希菌、肺炎克雷伯菌对头孢唑林、磺胺甲恶唑/甲氧苄啶、阿莫西林有耐药性;表皮葡萄球菌对青霉素、罗红霉素、磺胺甲噁唑/甲氧苄啶有耐药性;而金黄色葡萄球对青霉素、罗红霉素、阿奇霉素有耐药性。结论EICU患者常见感染部位为下呼吸道、血液系统;其感染风险较高,且多数为多药耐药菌感染;临床在抗感染治疗时,应灵活依据相关数据、质控指标,为患者选择合适抗菌药物。

Objective To explore the characteristics of pathogenic microorganism infection and bacterial resistance in emergency intensive care unit(EICU).Methods 486 patients admitted to EICU in the hospital from January 2018 to December 2018 were convenient selected.Pathogenic tests and pharmacological susceptibility tests were carried out to analyze the characteristics of pathogenic microorganism infection and bacterial resistance.Results Sputum(71.16%)and blood(18.62%)were the main samples of 486 patients.The positive rate of etiological test was 20.59%(272/1321),Gram-negative bacteria accounted for 55.00%(132/240),Gram-positive bacteria 17.92%(43/240)and fungal Candida albicans 27.08%(65/240).Escherichia coli and Klebsiella pneumoniae were resistant to cefazolin,sulfamethoxazole/trimethoprim and amoxicillin;Staphylococcus epidermidis was resistant to penicillin,roxithromycin,sulfamethoxazole/trimethoprim;and Staphylococcus aureus was resistant to penicillin,roxithromycin and azithromycin.Conclusion The common infection sites of EICU patients are lower respiratory tract and blood system.The risk of infection is high,and most of them are multi-drug resistant bacterial infection.In clinical anti-infection treatment,we should flexibly base on relevant data and quality control indicators to select suitable antibiotics for patients.