摘要
目的分析沈阳市某三甲医院呼吸重症监护室(RICU)患者相关样本病原菌分布及其耐药性,为呼吸重症患者感染的治疗提供参考。方法回顾性分析该院2021年6月至2022年6月收治的253例RICU患者的病例数据,通过API菌种鉴定系统及纸片扩散法药物敏感性试验检测送检的体液和组织标本中病原菌分布及其药敏情况。结果RICU患者检出阳性标本共147例,阳性率58.10%;检出革兰阳性细菌39株(11.24%)、革兰阴性细菌206株(59.37%)、真菌102株(29.39%)。占比排名前5位的病原菌为鲍曼不动杆菌(21.90%)、白假丝酵母菌(12.10%)、肺炎克雷伯菌(10.37%)、热带假丝酵母菌(7.49%)、铜绿假单胞菌(5.19%)。病原菌耐药性分析显示,鲍曼不动杆菌对常见抗生素均耐药;白假丝酵母菌对常用的抗生素均表现为敏感,但热带假丝酵母菌对伏立康唑和氟康唑的耐药率超过50.00%;相比痰液,尿液中肺炎克雷伯菌的耐药率较高;铜绿假单胞菌对亚胺培南、替卡西林/克拉维酸的耐药率均超过50.00%。结论该院RICU患者主要是以革兰阴性细菌和真菌感染为主,其中鲍曼不动杆菌和白假丝酵母菌所占比例较高,二者对常用的抗生素普遍耐药,临床可据此对病原菌耐药性的变化进行实时监测,为合理选用抗生素提供依据。
Objective To analyze the distribution and drug resistance of culture-positive pathogens in respiratory intensive care unit(RICU)patients from a tertiary hospital in Shenyang,providing a theoretical basis for the treatment of infection in patients with severe respiratory disease.Methods The data of 253 RICU patients admitted to our hospital from June 2021 to June 2022 were retrospectively analyzed.The distribution and drug sensitivity of pathogenic bacteria in body fluid and tissue samples were detected by using API strain identification system and disk dispersion method.Results A total of 147(58.10%)positive specimens were detected,including 39 strains of Gram-positive bacteria(11.24%),206 strains of Gram-negative bacteria(59.37%)and 102 strains of fungi(29.39%).The top five pathogens were Acinetobacter baumannii(21.90%),Candida albicans(12.10%),Klebsiella pneumoniae(10.37%),Candida tropicalis(7.49%),and Pseudomonas aeruginosa(5.19%).The resistance test results showed that Acinetobacter baumannii was generally resistant to common antibiotics;Candida albicans was sensitive to common antibiotics,but Candida tropicalis was more than 50.00%resistant to Voriconazole and Fluconazole.Compared with sputum,the drug resistance rates of Klebsiella pneumoniae in urine(to e.g.Ceftazidime,Ceftriaxone,Cefepime,Ampicillin/Sulbactam)increased.The resistance rates of Pseudomonas aeruginosa to Imipenem and Ticarcillin/Clavulanic acid exceeded 50.00%.Conclusion The pathogenic bacteria in the RICU of our hospital is mainly composed of Gram-negative bacteria and fungi.Acinetobacter baumannii and Candida albicans account for a high proportion.Both of them show universal resistance to commonly used antibiotics.Dynamic changes of drug resistance of pathogenic bacteria should be monitored in real time in clinical practice,so as to provide basis for rational selection of antibiotics.
作者
耿大升
李舒音
肖纯凌
刘光焱
徐天策
李新鸣
孙冶
GENG Da-sheng;LI Shu-yin;XIAO Chun-ling;LIU Guang-yan;XU Tian-ce;LI Xin-ming;SUN Ye(Department of Pathogenic Biology,Shenyang Medical College,Shenyang,Liaoning,110034,China;不详)
出处
《中国微生态学杂志》
CAS
CSCD
2023年第6期703-707,共5页
Chinese Journal of Microecology
基金
中国医药教育协会重大科学攻关问题和医药技术难题课题项目(2022KTM026)
关键词
呼吸重症监护室
病原菌感染
耐药性
Respiratory intensive care unit
Pathogenic bacterial infection
Drug resistance
