重症监护病房铜绿假单胞菌感染趋势及耐药监测(1)
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[摘要] 目的：了解重症监护病房铜绿假单胞菌(PA)的耐药率和抗菌药物使用变化情况，加强院内感染监测，指导临床合理用药。方法：分析我市三家综合性医院2006年1月~2010年12月重症监护病房各类送检标本中铜绿假单胞菌的感染趋势及耐药状况。结果：1 895例送检标本中共检出铜绿假单胞菌536株，检出率为28.3%，铜绿假单胞菌对15种常用抗菌药物呈不同程度的耐药，对阿米卡星、亚胺培南、环丙沙星等抗生素的耐药率较低。结论：铜绿假单胞菌是医院重症监护病房常见的病原菌，检出率、耐药率增长明显，必须加强抗菌药物合理应用的管理，严格消毒隔离措施，采用联合和交替用药等方法加以控制。
[关键词] 重症监护病房；铜绿假单胞菌；抗菌药物；耐药性
[中图分类号] R378.991 [文献标识码] B [文章编号] 1673-7210(2012)01(a)-090-02
Analysis of the drug resistance and the infection trend of pseudomonas aeruginosa in intensive care unit
YANG Yican, ZHU Qing, ZHAO Wanchun
The Second People's Hospital of Jingzhou City, Hubei Province, Jingzhou 434000, China
[Abstract] Objective: To investigate the changes of drug resistance rate of pseudomonas aeruginosa (PA) and the application of antibiotics in intensive care unit. Methods: The drug resistance and the infection trend of PA strains which were isolated from patients from January 2006 to December 2010 in three hospitals of our city were analyzed. Results: 536 strains of PA were isolated from 1 895 cases of sample, the total rate of isolation was 28.3%. There were different levels of drug resistance of PA to 15 kinds of common application antibiotics, and the drug resistance of PA to Amikacin, Imipenem, Ciprofloxacin was low. Conclusion: PA is the common pathogens in intensive care unit. The isolated rate and the drug resistance rate of PA are growth significantly. It is essential to strengthen the isolation measures, make reasonable use of antibiotics and adopt drug combination and replacement, in order to control PA infection.
[Key words] Intensive care unit; Pseudomonas aeruginosa; Anti-bacterial agents; Drug resistance
重症监护病房患者由于病情较为危重，住院时间长，机体免疫功能低下，长期使用广谱抗菌药物，接受较多侵入性操作，极易发生医院感染。铜绿假单胞菌是医院获得性感染的重要条件致病之一，该菌繁殖能力强且生长条件不高，长期住院、大量使用广谱抗生素、应用呼吸机、留置导尿管等都是导致其感染的危险因素，尤其在重症监护病房，是主要的医院感染病原菌，也是引起死亡的重要原因。本研究调查了本市三家医院重症监护室铜绿假单胞菌耐药率变化及抗菌药物使用情况，以期为今后的临床用药提供参考，缓解目前细菌的耐药状况。现报道如下：
1 资料与方法
1.1 一般资料
选择2006年1月~2010年12月本市三家综合医院(荆州市中心医院、荆州市第一人民医院、荆州市第二人民医院)重症监护病房分离的536株铜绿假单胞菌，剔除同一患者相同部位的重复菌株，分别来自痰、脓液、伤口、尿液、分泌物等标本。质控菌株为大肠埃希菌ATCC25922、铜绿假单胞菌ATCC27853，均来自湖北省临床检验中心 ......
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