论文部分内容阅读
目的探究重症监护病房(ICU)患发肺部感染患者的病原微生物分布状况,并对其耐药性进行分析,为临床合理用药提供参考。方法将沈阳市康平县人民医院检验科从2013年10月至2016年9月ICU收治的患发肺部感染患者110例作为研究对象,分别采集患者的呼吸分泌物与痰液标本并对其给予菌株鉴定,应用纸片扩散法完成药敏试验,回顾性分析患者分离出的病原菌分布情况以及耐药性。结果 110例肺部感染患者的痰液标本中共分离出232株病原微生物,主要有75.86%的革兰阴性菌,13.79%的革兰阳性菌,10.34%的真菌;铜绿假单胞菌、鲍氏不动杆菌以及嗜麦芽寡养单胞菌三种主要革兰阴性菌对氨苄西林与氨曲南等药物的耐药性偏高,对头孢哌酮/舒巴坦的耐药性最低;32株革兰阳性菌中有93.75%的耐甲氧西林葡萄球菌;真菌检查其对氟康唑及伊曲康唑两种药物的敏感性不足90.00%,对两性霉素B、氟胞嘧啶以及伊曲康唑、伏立康唑耐药性均较低。结论 ICU患发肺部感染患者多数是多重菌株混合感染,其中革兰阴性菌、革兰阳性菌以及真菌为主要病原微生物,最多见的是革兰阴性菌,分离出的病原菌大都表现为多药耐药性,临床治疗难度较高;临床必须重视预防ICU肺部感染的发生,同时要按照药敏试验结果为患者应用最合理的抗菌药物。
Objective To explore the distribution of pathogenic microorganisms in patients with lung infection in intensive care unit (ICU) and to analyze their drug resistance, so as to provide a reference for clinical rational drug use. Methods One hundred and eleven patients with pulmonary infection in ICU admitted from October 2013 to September 2016 in ICU were enrolled in this study. Respiratory secretions and sputum specimens of patients were collected and given Strain identification, application of disk diffusion method to complete drug susceptibility testing, retrospective analysis of patients isolated from the distribution of pathogens and drug resistance. Results A total of 232 pathogenic microorganisms were isolated from sputum specimens of 110 patients with pulmonary infection, including 75.86% Gram-negative bacteria, 13.79% Gram-positive bacteria and 10.34% fungi; Pseudomonas aeruginosa, Acinetobacter and Stenotrophomonas maltophilia three major gram-negative bacteria ampicillin and aztreonam and other drugs high resistance to cefoperazone / sulbactam the lowest resistance; 32 Gram-positive bacteria in 93.75% of methicillin-resistant Staphylococcus aureus; fungal examination of fluconazole and itraconazole two drugs less than 90.00% sensitivity to amphotericin B, flucytosine and it Conazole, voriconazole resistance are low. Conclusions The majority of ICU patients with pulmonary infection are mixed infections of multiple strains, of which Gram-negative bacteria, Gram-positive bacteria and fungi are the major pathogenic microorganisms. The most common are Gram-negative bacteria. Most isolated pathogenic bacteria are multi-drug Drug resistance, clinical treatment is more difficult; clinical must pay attention to prevent the occurrence of pulmonary infection in ICU, at the same time according to drug susceptibility test results for patients with the most reasonable antimicrobial drugs.