ICU下呼吸道感染患者多重耐药菌的耐药性及感染因素分析

Drug resistance and infection factors of multidrug-resistant bacteria in ICU patients with lower respiratory tract infection

目的分析医院ICU下呼吸道感染患者中感染多重耐药菌的种类、耐药性,以及可能致其发生的高危影响因素。方法收集获得符合标准的2018年1月至2019年12月火炬开发区医院ICU收治的下呼吸道感染患者51例,采集痰液标本进行鉴定,并进行药敏分析,对日常ICU治疗操作中可能致耐药菌感染的影响因素进行统计分析。结果51例患者痰液标本中共分离得到54株细菌株,革兰阴性菌51株,革兰阳性菌3株;检出多重耐药菌29株,鲍曼不动杆菌和肺炎克雷伯菌的耐药性较高;留置胃管和有创机械通气在多重耐药组中具有显著差异。结论医院ICU下呼吸道感染多重耐药菌多以肺炎克雷伯菌和鲍曼不动杆菌为主,并且耐药性较高,留置胃管和有创机械通气可能是多重耐药菌发生的影响因素。在治疗过程中,应规范操作,密切监测,减少多重耐药菌的发生发展。

Objective To analyze the types,drug resistance,and high-risk factors of multidrug-resistant bacteria,and to identify the factors that may cause their occurrence in ICU patients with lower respiratory tract infection.Methods 51 ICU patients with lower respiratory tract infection treated at Hospital of Huoju Development Zone were collected from Jan.2018 to Dec.2019.Their sputum samples were collected for bacterial identification and drug susceptibility analysis.The factors that might occur during routine ICU treatment operations were collected and statistically analyzed.Results A total of 54 bacterial strains,51 gram-negative bacterial strains and 3 gram-positive bacterial strains,were isolated from the sputum samples.29 multi-drug resistant bacterial strains were detected.Drug susceptibility analysis showed that Acinetobacter baumannii and Klebsiella pneumoniae had higher drug resistance.And statistical analysis revealed that indwelling gastric tube and invasive mechanical ventilation had significant differences in the multidrug resistance group.Conclusion Multi-drug resistant bacteria in ICU lower respiratory tract infection mostly are Klebsiella pneumoniae and Acinetobacter baumannii,and always with a characteristic of high drug resistance.Indwelling gastric tube and invasive mechanical ventilation may be the influencing factors of the occurrence of multi-drug resistant bacteria.Therefore,in the course of treatment,standardized operations and closely monitoring should perform standardly to reduce the occurrence of multi-drug resistant bacteria.