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1、第19卷第14期中國現(xiàn)代醫(yī)學(xué)雜志Vol.19No.142009年7月ChinaJournalofModernMedicineJul.2009文章編號:1005-8982(2009)14-2196-03重癥監(jiān)護(hù)病房患者醫(yī)院內(nèi)獲得性肺炎細(xì)菌學(xué)特點(diǎn)及其耐藥性分析王小智,周森,韓魁,陳志樂(海南省農(nóng)墾總局醫(yī)院ICU,海南???70311)摘要:目的探討重癥監(jiān)護(hù)病房患者醫(yī)院內(nèi)獲得性肺炎細(xì)菌分布特點(diǎn)及耐藥情況。方法回顧性總結(jié)該院重癥監(jiān)護(hù)病房69例醫(yī)院內(nèi)獲得性肺炎患者的臨床資料、感染細(xì)菌譜及耐藥性,并對相關(guān)因素進(jìn)行分析。結(jié)果69例感染患者共
2、分離出細(xì)菌118株,以G-桿菌為主(占83.89%),G+球菌比例較低(占16.10%)。G-桿菌中銅綠假單胞菌占第1位(22.03%),其次為大腸埃希菌(20.33%)、肺炎克雷伯(16.94%)。G+球菌占16.10%,主要為金黃色葡萄球菌,其中耐甲氧西林金黃色葡萄球菌占70%。結(jié)論ICU患者醫(yī)院內(nèi)獲得性肺炎的細(xì)菌以G-桿菌為主,且多重耐藥,對重癥感染患者應(yīng)多種抗菌藥物聯(lián)合使用以減少細(xì)菌耐藥率的發(fā)生,應(yīng)根據(jù)藥敏試驗(yàn)合理選用抗菌藥物,動(dòng)態(tài)監(jiān)測抗生素耐藥情況對患者積極有效的治療至關(guān)重要。關(guān)鍵詞:醫(yī)院內(nèi)肺炎;細(xì)菌學(xué);耐藥性中圖分
3、類號:R563.11文獻(xiàn)標(biāo)識碼:BAnalysisofnosocomialpathogensanddrugresistanceinpatientswithlowerrespiratorytractinfectioninintensivecareunitWANGXiaozhi,ZHOUSeng,HANKui,CHENZhile(GeneralHospitalofHainanProvincialBureauofAgriculturalReclamation.HaikouHainan570311,P.R.China)Abstract
4、:【Objectives】Toinvestigatethedistributionofpathogenicbacteriaandtheirantibioticresistanceinsenilepatientswithnosocomialpneumoniainintensivecareunit.【Method】Theclinicaldata,bacterialspectrtun,drugresistanceandrelatedfactorsofintensivecareunitpatientsinourhospitalwere
5、analyzedretrospectively.【Results】Atotalof118pathogensstrainswereidentifiedfromthesputumin69patients.Therateofgram-negativebacteriaandgram-positivebacteriawere83.8%and16.10%respectively.Pseudomonasaeruginosaranksthefirstofgram-negativebacteria,followedbyEscherichiaco
6、liandKlebsiellapneumoniaeaccountedfor20.33%and16.94%respectively.Amonggram-positivebacteriastrainstheStphylococusauruginosawasmainlysub-jects,therateofmethicillin-resistantStaphylococcusaureus(MRSA)was70%.【Conclusions】Gram-negativebacteria,whichpresentwithmulti-drug
7、resistantpattern,werethemostcommonpathogenicbacteriainsenilepa-tientswithnosocomialpneumoniainintensivecareunit.Inordertodecreasetherateofantibioticresistance,weshouldcombinateseveralantibioticsforseriousinfection.Thedrugsensitivitytestrequiredweresignificantinprope
8、rselectionofantibiotics.Monitoringthedrugresistanceofbacteriatoantibioticswillbevitalimportanttocuresenilepatientswithlowerrespiratorytrac