基层医院ICU与非ICU主要革兰阴性杆菌分布与耐药性差异
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李春辉

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R181.3+2

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湖南省科技计划项目(2012SK3200)


Distribution and antimicrobial resistance of major gramnegative bacilli in ICU and nonICU wards in a grassroots hospital
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    摘要:

    目的了解医院重症监护室(ICU)与非ICU主要革兰阴性(G-)杆菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法对某院2011—2013年住院患者送检标本中培养分离的G-菌标本来源及耐药性进行统计分析,比较ICU与非ICU的差异。结果25 153份标本共分离G-菌3 875株,分离率15.41%;其中ICU 1 121份标本中分离G-菌527株,分离率47.01%,非ICU 24 032份标本分离 G-菌3 348株,分离率13.93%,两者比较差异有统计学意义(χ2=899.32,P<0.001)。 大肠埃希菌和肺炎克雷伯菌产超广谱β内酰胺酶(ESBLs)菌株检出率:ICU分别为56.00%(28/50)、70.65%(65/92),非ICU分别为52.81%(517/979)和40.37%(241/597)。ICU中铜绿假单胞菌、鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌对亚胺培南的耐药率分别为36.59%、88.54%、10.00%、10.87%,均高于非ICU同类菌的耐药率,分别为20.21%、61.15%、1.74%、2.85%。结论ICU主要G-杆菌的耐药率高于非ICU,且以多重耐药的非发酵菌为主。临床治疗应区别对待,以减少耐药菌的产生。

    Abstract:

    ObjectiveTo investigate the distribution and antimicrobial resistance of major gramnegative bacilli isolated from patients in intensive care unit (ICU) and nonICU wards,and provide reference for rational clinical antimicrobial  application. MethodsSpecimen sources and antimicrobial resistance of gramnegative bacilli from hospitalized patients in ICU and nonICU wards between 2011 and 2013 were analyzed statistically and compared.ResultsA total of  3 875 gramnegative bacterial isolates were detected among 25 153 specimens, isolation rate was 15.41%; 1 121 specimens from ICU were isolated 527 isolates of gramnegative bacilli, isolation rate was  47.01%; 3 348 isolates of  gramnegative bacilli were isolated from 24 032 specimens of nonICU, isolation rate was 13.93%, there was significant difference between the two(χ2=899.32,P<0.001). Extendedspectrum βlactamases (ESBLs)producing rate of Escherichia coli and Klebsiella pneumoniae in ICU patients was 56.00%(28/50) and 70.65%(65/92) respectively, in nonICU patients was 52.81%(517/979) and 40.37%(241/597)respectively. The imipenemresistant rate of Pseudomonas aeruginosa, Acinetobacter baumannii,  Escherichia coli, and Klebsiella pneumoniae from ICU was 36.59%, 88.54%, 10.00%, and 10.87% respectively, while from nonICU was 20.21%, 61.15%, 1.74%, and 2.85% respectively,the resistant rates of strains from ICU were higher than nonICU.ConclusionAntimicrobial resistant rates of major gramnegative bacilli from ICU are higher than those from nonICU, and the main strains are multidrugresistant nonfermentative bacteria. Clinical treatment should be different to reduce the emergence of drugresistant bacteria.

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杜静,龙继川,李春辉.基层医院ICU与非ICU主要革兰阴性杆菌分布与耐药性差异[J]. 中国感染控制杂志,2015,14(7):468-471. DOI:10.3969/j. issn.1671-9638.2015.07.009.
DU Jing, LONG Jichuan, LI Chunhui. Distribution and antimicrobial resistance of major gramnegative bacilli in ICU and nonICU wards in a grassroots hospital[J]. Chin J Infect Control, 2015,14(7):468-471. DOI:10.3969/j. issn.1671-9638.2015.07.009.

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  • 收稿日期:2015-02-08
  • 最后修改日期:2015-04-12
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  • 在线发布日期: 2015-07-30
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