ICU多重耐药菌定植调查及耐药性分析 FREE

Colonization and drugresistance of multidrugresistant bacteria in intensive care unit FREE

摘要:

目的了解某院重症监护室（ICU）患者体内多重耐药菌的定植情况和耐药特点。方法应用细菌学监测的方法对2008年11月—2009年4月入住该院ICU的82例患者鼻前庭拭子和直肠拭子进行筛查培养，并做药敏试验。采用WHONET5.4软件进行数据分析。结果在38例患者标本中检测到多重耐药菌，定植率为46.34%。包括62株产超广谱β内酰胺酶（ESBLs）肠杆菌科细菌和4株耐甲氧西林金黄色葡萄球菌（MRSA），未检测到多重耐药的鲍曼不动杆菌和铜绿假单胞菌。62株产ESBLs肠杆菌科细菌对亚胺培南、美罗培南耐药率 (4.84%) 低，对其他抗菌药物耐药率较高，不同细菌耐药情况不尽相同；4株MRSA除对万古霉素、替考拉宁、利奈唑胺完全敏感，对克林霉素、磷霉素和庆大霉素部分敏感外，对其他抗菌药物均耐药。结论该院 ICU患者体内多重耐药菌定植率高，耐药现象严重，应引起临床医生的高度重视，加强监测，避免多重耐药菌在医院暴发流行。

Abstract:

 Objective   To understand the colonization and resistance characteristics of multidrugresistant bacteria  isolated from ICU patients. Methods  Nasal vestibular  and rectal swabs of 82 patients  admitted in a hospital ICU from November, 2008 to April, 2009 were screened by bacteriological surveillance method, and antimicrobial susceptibility were performed. Data were analyzed by WHONET5.4 software. Results  Multidrugresistant strains were detected among 38 patients , the colonization rate was 46.34%, which including 62 strains of extendedspectrum β lactamases (ESBLs) producing Enterobacteriaceae bacteria and 4 strains of methicillinresistant Staphylococcus aureus(MRSA),  and multidrugresistant Acinetobacter baumannii and Pseudomonas aeruginosa was not detected. 62  strains of ESBLsproducing strains had lower drugresistant rates (4.84%)  to imipenem and meropenem,but had high sensitive rates to the other antimicrobial agents, resistant rates varied with different  bacteria; 4  MRSA strains were all sensitive to vancomycin, teicoplanin and linezolid, some were sensitive to clindamycin, fosfomycin and gentamicin, and all were resistant to other antimicrobials.Conclusion  Colonization rate of multidrugresistant bacteria is high in patients in  ICU, and drugresistance is serious, which should be paid attention by clinicians , surveillance should be intensified , so as to avoid the outbreak of multidrugresistant bacteria infection in hospital.