【摘要】 目的调查医院重症监护病房(ICU)下呼吸道医院感染的革兰阴性杆菌分布及耐药性,为临床医师合理用药提供科学依据。方法病原菌分离培养按《全国临床检验操作规程》进行;菌株鉴定采用法国生物梅里埃公司VITEK-32全自动微生物分析仪进行;药物敏感试验采用K-B法,结果依据CLSI 2008-2009年折点判读。结果 217株革兰阴性杆菌分离率居前4位的依次为铜绿假单胞菌(24.9%)、肺炎克雷伯菌(16.6%)、大肠埃希菌(13.4%)、鲍氏不动杆菌(15.2%);4种重要病原菌均产生了严重的耐药性,除碳青霉烯类抗菌药物对肠杆菌科细菌尚保持了100.0%的抗菌活性外,PAE及ABA对碳青霉烯类抗菌药物已产生了10.1%～11.9%的耐药率;铜绿假单胞菌及鲍氏不动杆菌已出现泛耐药菌株。结论 ICU下呼吸道医院感染的革兰阴性杆菌多为多药耐药菌,应加强监测与控制。更多还原

【Abstract】 OBJECTIVE To investigate flora distribution and antibiotical resistance of lower respiratory tract infection with gram negative bacilli in intensive care unit(ICU) and provide the scientific reference for clinically reasonable use of antibiotics.METHODS Referring to National guide to clinical laboratory procedures,the strains were isolated and cultured.The bioMérieux VITEK 32 was used to identify the strains.The antibiotical susceptibility testing wes performed by K-B methods and the results were read according to CLSI 2008-2009.RESULTS Among 217 strains of gram negative bacilli,the top 4 of isolateing rate were Pseudomonas aeruginosa(24.9%),Klebsiella pneunmoniae(16.6%),Escherichia coli(13.4%) and Acinetobacter baumannii(15.2%),respectively.The drug-resistance supervision in vitro manifested that the severe drug resistance occurred in four species of important pathogene.Except for 100.0% susceptibility of Enterobacteriaceae to carbopenems,the drug resistance rate of carbopenems in P.aeruginosa and A.baumannii arrived at 10.1%-11.9%.The pan-drug resistant strains emerged in A.baumannii and P.aeruginosa.CONCLUSION The Gram-negative bacilli isolated from lower respiratory tract in nosocomial infections in ICU are mostly multi-resistant strains.We should strengthen monitoring and controlling of them.更多还原