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目的探讨引起重症监护(ICU)病区患者肺部感染的菌群分布及耐药性,为临床预防控制肺部院内感染及治疗提供直接可靠的参考依据。方法对ICU病区2007年1月至2008年12月期间痰标本分离培养出的主要病原菌分布及耐药性进行回顾性分析。结果痰培养分离出的病原菌以革兰氏阴性杆菌为主,首是鲍曼氏不动杆菌,依次顺序为铜绿假单胞菌、白色念珠菌、金黄色葡萄球菌、嗜麦芽窄食单胞菌、大肠埃希氏菌、肺炎克雷伯菌等。鲍曼氏不动杆菌、铜绿假单胞菌耐药率最高的是复方新诺明;白色念珠菌耐药率最高的是伊曲康唑;金黄色葡萄球菌耐药率最高的是青霉素;嗜麦芽窄食单胞菌对多种抗生素表现出高度耐药。结论革兰氏阴性杆菌仍是ICU病区肺部感染的主要菌群,特别是鲍曼氏不动杆菌,已成为ICU病区肺部感染的主要病原菌,且ICU肺部感染常呈交叉感染,因此预防肺部感染及交叉感染和降低耐药性已成为ICU病区当前的主要任务之一。
Objective To investigate the distribution and drug resistance of pulmonary flora in patients with intensive care unit (ICU) and provide a direct and reliable reference for clinical prevention and control of pulmonary nosocomial infections. Methods The distribution and drug resistance of major pathogenic bacteria isolated from sputum from January 2007 to December 2008 in ICU ward were retrospectively analyzed. Results The pathogens isolated from sputum culture were Gram-negative bacilli and Acinetobacter baumannii first, followed by Pseudomonas aeruginosa, Candida albicans, Staphylococcus aureus, Stenotrophomonas maltophilia Escherichia coli, Klebsiella pneumoniae and so on. Acinetobacter baumannii, the highest rate of Pseudomonas aeruginosa is cotrimoxazole; the highest rate of Candida albicans is itraconazole; the highest rate of Staphylococcus aureus is penicillin; Smaller malt is highly resistant to a wide range of antibiotics. Conclusions Gram-negative bacilli are still the main group of pulmonary infection in ICU, especially Acinetobacter baumannii, which has become the main pathogen of pulmonary infection in ICU ward. The lung infection in ICU often shows cross infection, Therefore, preventing lung infections and cross-infection and reducing drug resistance has become one of the major tasks in the current ICU ward.