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毛彦华,刘锦铭,陈慧萍,等.重症监护病房下呼吸道感染病原菌分布和耐药性分析[J].同济大学学报（医学版）,2011,32(2):84-88. [点击复制]
MAO Yan-hua,LIU Jing-min,CHEN Hui-ping,et al.Analysis of distribution and drug resistance of pathogens of lower respiratory tract infections in ICU[J].同济大学学报（医学版）,2011,32(2):84-88. [点击复制]

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重症监护病房下呼吸道感染病原菌分布和耐药性分析
毛彦华¹,刘锦铭²,陈慧萍³,王暖³
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(1. 同济大学附属肺科医院感染管理科,上海 200433;2. 同济大学附属肺科医院呼吸科,上海 200433;3. 同济大学附属肺科医院检验科,上海 200433)

摘要:

目的分析2007—2009年重症监护病房（intensive care unit,ICU）下呼吸道感染病原菌分布和耐药性,为医院感染控制和临床合理应用抗菌药物提供依据。方法对分离培养出的266株感染病原菌,采用MIC法进行药敏试验,使用WHONET 5.4软件进行分析。结果下呼吸道感染病原菌主要为G-杆菌,占66.54%,常见为：鲍曼不动杆菌（30.83%）、铜绿假单胞菌（13.53%）、肺炎克雷伯菌（8.65%）;G＋球菌占16.92%,以金黄色葡萄球菌为主（11.65%）;真菌感染占16.54%。非发酵G-菌对包括亚胺培南在内的绝大多数抗菌药物耐药;耐甲氧西林的金黄色葡萄球菌检出率高达80%以上。结论 ICU非发酵G-菌和金黄色葡萄球菌耐药性严重,有增加趋势。应重视合理应用抗菌药物,并采取措施防止医源性交叉感染。

关键词: 重症监护病房下呼吸道感染病原菌耐药性

DOI：10.3969/j.issnl008-0392.2011.02.021

基金项目:

Analysis of distribution and drug resistance of pathogens of lower respiratory tract infections in ICU

MAO Yan-hua¹,LIU Jing-min²,CHEN Hui-ping³,WANG Nuan³

(1.Dept.of Nosocomial Infection Control,Pulmonary Hospital,Tongji University,Shanghai 200433,China;2.Dept.of Respiratory Medicine,Pulmonary Hospital,Tongji University,Shanghai 200433,China;3.Dept.of Clinical Laboratory,Pulmonary Hospital,Tongji University,Shanghai 200433,China)

Abstract:

Objective To analyze the bacterial distribution and resistance of pathogens of lower respiratory tract infections in intensive care unit(ICU) from 2007 to 2009 to provide basis for infection control and the better administration of antibiotics.Methods Mean inhibitory concentration(MC) tests were conducted to detect the antimicrobial sensitivity of 266 bacterial strains.WHONET5.4 was applied to analyze the bacterial distribution and resistance data.Results The main pathogens were Gram-negative strains accounting for 66.54%.Acinetobacter baumannii(30.83%),Pseudomonas aeruginosa(13.53%) and Klebsiella pneumoniae (8.65%)were the most common Gram-negative isolates.16.92%of total isolates were Gram-positive strains, of which 11.65%were Staphylococus aureus.The percentage offungi was 16.54%.The resistance of Gram- negative non-fermenting bacteria to most antibiotics(including Imipenem) was severe.The resistant rates of Staphylococus aureus to oxacillin was up to 80%.Conclusions In view of the increasing multidrug resistance of Gram-negative non-fermenting bacteria and Staphylococus aureus in ICU,rational administration of antibiotics and iatrogenic infection prevention measures should receive great attention.

Key words: intensive care unit lower respiratory tract infection pathogens drug resistance