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目的探讨综合监护室(ICU)患者多重耐药菌感染情况及分析其药物敏感性试验结果,为ICU感染防控提供理论依据。方法对2016年1—12月山东省济宁市第一人民医院从ICU患者送检的所有细菌培养加药敏样本中检出的多重耐药菌(主要为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、耐甲氧西林金黄色葡萄球菌、肺炎克雷伯菌和耐万古霉素肠球菌)进行多重耐药菌药物敏感性试验。结果共检出多重耐药菌433株,占总阳性样本数的42.7%(433/1 014)。主要有鲍曼不动杆菌(占41.6%,180/433)、铜绿假单胞菌(占22.9%,99/433)、大肠埃希菌(占15.5%,67/433)、耐甲氧西林金黄色葡萄球菌(9.9%,43/433)、肺炎克雷伯菌(4.2%,18/433)、耐万古霉素肠球菌(占1.7%,3/433)。菌株来源依次为下呼吸道分泌物(占75.3%,326/433)、中段尿(占10.9%,47/433)、血液(占6.5%,28/433)、分泌物(占3.2%,14/433)、脑脊液(占1.4%,6/433)、导管尖端(占1.4%,6/433)、穿刺液(占0.5%,2/433)、胸水(占0.5%,2/433)和脓液(占0.5%,2/433)。革兰氏染色阴性多重耐药菌对常用抗菌药物普遍存在耐药性。结论 ICU患者多重耐药菌检出率高,抗生素耐药率高,应加强科室防控,防止多重耐药菌的发生及传播。
Objective To investigate the multi-drug resistant bacterial infections in intensive care unit (ICU) patients and to analyze the results of their drug susceptibility test to provide a theoretical basis for prevention and control of ICU infection. Methods From January to December in 2016, Jining City, Shandong Province First People’s Hospital of ICU patients from all drug-tested samples of drug-susceptible strains were detected (mainly Acinetobacter baumannii, Pseudomonas aeruginosa Bacteria, Escherichia coli, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae and vancomycin-resistant enterococci) were tested for susceptibility to multiple drug-resistant bacteria. Results A total of 433 multi-resistant strains were detected, accounting for 42.7% (433/1 014) of the total positive samples. Acinetobacter baumannii (41.6%, 180/433), Pseudomonas aeruginosa (22.9%, 99/433), Escherichia coli (15.5%, 67/433), methicillin-resistant Staphylococcus aureus (9.9%, 43/433), Klebsiella pneumoniae (4.2%, 18/433), and vancomycin-resistant enterococci (1.7%, 3/433). The strains were followed by lower respiratory secretions (75.3%, 326/433), middle urine (10.9%, 47/433), blood (6.5%, 28/433), secretions (3.2% (1.4%, 6/433), catheter tip (1.4%, 6/433), puncture fluid (0.5%, 2/433), pleural effusion Liquid (0.5%, 2/433). Gram-negative multi-drug-resistant bacteria commonly used antimicrobial resistance. Conclusion The detection rate of multidrug-resistant bacteria in ICU patients is high, and the rate of antibiotic resistance is high. Prevention and control of departments should be strengthened to prevent the occurrence and spread of multi-drug resistant bacteria.