标题:2017年东莞地区重症监护病房病原菌分布及耐药性监测
作者:段俊林,陈伟,卢丽娟 东莞市中医院检验科,广东 东莞 523000
卷次:
2019年30卷7期
【摘要】 目的 了解东莞地区重症监护病房(ICU)常见病原菌临床分布和耐药性情况,为合理使用抗菌药物、有效控制感染提供依据。方法 对2017年1~12月东莞地区20家参加细菌耐药监测的医疗机构的 ICU患者常见病原菌分布和耐药性进行回顾性分析。结果 共分离出病原菌4 848株,其中革兰阴性杆菌3 386株(69.8%),革兰氏阳性球菌1 209株(24.9%),真菌253株(5.2%)。革兰阴性杆菌前五位依次为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌、嗜麦芽窄食单胞菌。革兰氏阳性球菌前五位依次为金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌、溶血葡萄球菌、粪肠球菌。药敏结果显示,肠杆菌科细菌对第三代头孢菌素耐药率较高,对阿米卡星、亚胺培南和哌拉西林/他唑巴坦保持较高的敏感性;革兰阳性球菌中的葡萄球菌对青霉素、克林霉素和红霉素耐药率高,未发现对万古霉素不敏感的葡萄球菌;检出6株耐万古霉素肠球菌(VRE)。结论 2017年东莞地区 ICU病原菌以革兰阴性杆菌为主,且耐药严重,应加强 ICU病原菌耐药性的监测,指导临床合理用药以控制耐药菌的产生。
【关键词】 重症监护病房;病原菌分布;抗菌药物;药敏试验;耐药性
【中图分类号】 R37 【文献标识码】 A 【文章编号】 1003—6350(2019)07—0865—04
Distribution and drug resistance analysis of pathogenic bacteria in Intensive Care Units in Dongguan area in2017.
DUAN Jun-lin, CHEN Wei, LU Li-juan. Department of Clinical Laboratory, Dongguan Traditional Chinese MedicineHospital, Dongguan 523000, Guangdong, CHINA
【Abstract】 Objective To understand the clinical distribution and drug resistance of common pathogens in In-tensive Care Unit (ICU) in Dongguan area and to provide reference for clinical drug administration. Methods Thepathogen bacteria in ICU isolated from hospitalized patients in 20 medical institutions which participated in bacterialmonitoring in Dongguan between January 2017 and December 2017 were retrospectively analyzed. Results A total of4 848 strains of pathogenic bacteria were detected, including 3 386 strains of Gram-negative (G-) bacillus (69.8%), 1 209strains of Gram-positive (G+) cocci (24.9%), 253 strains of fungi (5.2%). The top five G- bacillus were Klebsiella pneu-moniae, Escherichia coli, Pseudomonas aeruginosa, Acinetobacter baumannii, and Stenotrophomonas maltophilia. The topfive G + were Staphylococcus aureus, Staphylococcus epidermidis, Enterococcus faecalis, Staphylococcus haemolyticus, andEnterococcus faecalis. The antimicrobial susceptibility results showed that the resistance rate of Enterobacteriaceae bacte-ria to the third-generation cephalosporin was relatively high, and high sensitivity was maintained to amikacin, imipenem,and piperacillin/tazobatan. Staphylococcus is highly resistant to penicillin, clindamycin and erythromycin, no vancomy-cin-resistant Staphylococcus had been found. Six strains of vancomycin-resistant enterococcus (VRE) were detected.Conclusion The pathogenic bacteria of ICU in Dongguan area were mainly Gram-negative bacillus during 2017, anddrug resistance is severe. Bacterial resistance monitoring should be performed in ICU to prevent the generation of antibi-otic resistant bacteria.
【Key words】 Intensive Care Unit (ICU); Bacterial distribution; Antibacterial drugs; Antimicrobial susceptibilitytest; Drug resistance
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