文章摘要

基层医院ICU院内感染的细菌分布及耐药分析

作者: 1严杰, 2赵卉
1 合肥庐江县人民医院呼吸与危重症医学科,合肥 231500
2 安徽医科大学第二附属医院呼吸内科,合肥 230601
通讯: 赵卉 Email: zhaohuichenxi@126.com
DOI: 10.3978/j.issn.2095-6959.2021.03.008

摘要

目的:探讨重症监护室(intensive care unit,ICU)院内感染的病原学特征和耐药性情况。方法:统计2016年1月至2018年12月在庐江县人民医院ICU治疗的院内感染患者,从检验科收集上述患者的病原菌标本培养及药敏结果,比较不同时期病原菌的变化及耐药情况。结果:2016、2017和2018年共检出病原菌238株,主要为革兰氏阴性菌;2016年前三菌属为不动杆菌属、克雷伯菌属和假单胞菌属;2017年和2018年前三菌属为克雷伯菌属、不动杆菌属和假单胞菌属。不同年份菌株类型和菌属分布差异有统计学意义(P<0.05)。肺炎克雷伯菌、铜绿假单胞菌对阿米卡星耐药性逐年升高,差异有统计学意义(P<0.05),多重耐药菌占比有上升趋势。结论:ICU发生院内感染的病原菌以革兰氏阴性菌为主,菌属分布存在变化,同时,细菌的耐药性在上升,需进一步强化抗菌药物的管理。
关键词: 重症监护室;呼吸机相关性肺炎;病原学;耐药性

Analysis of bacterial distribution and drug resistance in ICU of primary hospital

Authors: 1YAN Jie, 2ZHAO Hui
1 Department of Respiratory and Critical Care Medicine, Lujiang County People’s Hospital, Hefei 231500, China
2 Department of Respiratory Medicine, Second Affiliated Hospital, Anhui Medical University, Hefei 230601, China

CorrespondingAuthor: ZHAO Hui Email: zhaohuichenxi@126.com

Abstract

Objective: To investigate the pathogenic characteristics and drug resistance of nosocomial infection in intensive care unit (ICU). Methods: Nosocomial infection patients who were treated in ICU of Lujiang County People’s Hospital from January 2016 to December 2018 were selected. Pathogen sample culture and drug sensitivity results of these patients were collected from the Laboratory Department. The data were retrospectively investigated and analyzed to compare the changes of pathogens and drug resistance in different periods. Results: In 2016, 2017 and 2018, a total of 238 pathogens were detected, and the main strains were Gram-negative bacteria; the top 3 of 2016 were Acinetobacter, Klebsiella, and Pseudomonas; the top 3 of 2017 and 2018 were Klebsiella, Acinetobacter, and Pseudomonas. There were significant differences in the types and distribution of strains in different years (P<0.05). The resistance of Klebsiella pneumoniae and Pseudomonas aeruginosa to amikacin increased year by year, with statistically significant difference (P<0.05), and the proportion of multiple drug resistant organisms increased. Conclusion: The main pathogens of nosocomial infection in ICU were Gram-negative bacteria. The distribution of bacteria has changed. Drug resistance is on the rise; therefore, strict management of antibiotics should be further strengthened.
Keywords: intensive care unit; ventilator-associated pneumonia; etiology; drug resistance