2018年ICU革兰氏阴性菌的耐药情况分析

Analysis of Drug Resistance of ICU Gram-negative Bacteria in 2018

目的:分析我院2018年ICU科室革兰阴性菌耐药情况,为临床用药选择提供合理的参考。方法:收集我院ICU送检的细菌培养标本,采用仪器VITEK 2 Compact进行细菌鉴定和药敏试验,数据采用WHONET5.6软件对筛选的革兰阴性菌进行统计学分析。结果:2018年我院ICU共分离335株革兰阴性菌,常见的革兰阴性菌有肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌、铜绿假单胞菌、阴沟肠杆菌。肺炎克雷伯菌、大肠埃希菌,阴沟肠杆菌对复方新诺明耐药率高,对头孢类耐药率较高,对亚胺培南和阿米卡星耐药率低。鲍曼不动杆菌对多种抗菌药呈现高耐药率。铜绿假单胞菌对所测的抗菌药的耐药率在18.18%~36.36%。结论:ICU院内革兰阴性菌耐药情况比较严峻,临床应当合理使用抗菌药物,加强细菌耐药的监测。

Objective:To analyze the drug resistance of Gram-negative bacteria in the ICU department of our hospital in 2018,so as to provide a reasonable reference for clinical drug selection.Method:Collect the bacterial culture specimens sent by the ICU in our hospital,use the instrument VITEK 2 Compact for bacterial identification and drug susceptibility test,and the data were analyzed statistically with the NET negative software by WHONET5.6 software.Results:A total of 335 Gram-negative bacteria were isolated from ICU in 2018.Common Gram-negative bacteria include Klebsiella pneumoniae,Acinetobacter baumannii,Escherichia coli,Pseudomonas aeruginosa,and Enterobacter cloacae.Klebsiella pneumoniae,Escherichia coli,and Enterobacter cloacae have a high resistance rate to compound sinophenamine,a high resistance rate to cephalosporins,and a low resistance rate to imipenem and amikacin.Acinetobacter baumannii presents a high rate of resistance to various antibacterial drugs.The resistance rate of Pseudomonas aeruginosa to the tested antibacterial drugs is 18.18%~36.36%.Conclusion:The drug resistance of gram-negative bacteria in ICU hospitals is relatively severe.Antimicrobial drugs should be used rationally in clinic and the monitoring of bacterial drug resistance should be strengthened.