【摘要】 目的:了解我院PICU下呼吸道感染患者致病菌种类分布及药敏情况,提出指导PICU医生合理使用抗生素的建议,为有效控制PICU院内感染提供依据。方法:回顾性分析2011年3月~2012年12月我院PICU肺炎患儿下呼吸道感染患者的的细菌培养和药敏分析结果。结果:共分离出403株病原菌,其中革兰氏阴性杆菌286株,占71%,主要为大肠杆菌、肺炎克雷伯菌。对一代头孢菌素普遍产生较高耐药,对二代头孢菌素也同样产生较高耐药,未发现有对亚胺培南耐药杆菌。革兰氏阳性球菌117株,占29%,主要为肺炎链球菌。对红霉素、克林霉素、阿奇霉素耐药率较高,对青霉素、左氧氟沙星、头孢呋辛耐药率较低,未发现耐万古霉素球菌。结论:本院PICU患者痰液的主要病原菌以革兰氏阴性杆菌为主,并且可能成为今后院内小儿下呼吸道感染的首位致病菌。医院应重视PICU病房的消毒管理,用药时应参考细菌的药敏结果合理选择抗生素,对降低耐药性和采取有效措施控制院内感染是非常重要的。更多还原

【Abstract】 Objective:To understand the pathogen species distribution and drug resistance of patients with lower respiratory tract infection in our hospital in PICU,Proposing guidance for PICUdoctors rational use of antibiotics,to provide a basis for effective control of infection in PICU.Methods:A retrospective analysis of the bacterial culture and drug sensitivity results of pneumonia children with lower respiratory tract infections.from March 2011 to December 2012 in PICUof our hospital.Results:A total of 403 strains of pathogens isolated,including 286 strains of gram negative bacilli,accounted for 71%,mainly for Escherichia coli,and Klebsiella pneumoniae.Generally have higher resistance to the first generation of cephalosporins,have resistance tothe second generation of cephalosporins too,and imipenem-resistant tuberculosisis not found.117 strainsof gram positive cocci,accounted for 29%,mainly for Streptococcus pneumoniae.Higher resistance rates to erythromycin, clindamycin,and azithromycin,to erythromycin,clindamycin,lower resistance rates to penicillin,levofloxacin, cefuroxime,found no vancomycin-resistant cocci.ConclusionThe main pathogenic bacteria in the sputum of patients with PICU are mainly gram-negative bacillus,and that may become the first pathogens of children with lower respiratory tract infection in the future.Clinical attention should be paid to the disinfection management of PICU ward,medication should reference bacteria drug sensitivity results to have a reasonable choice of antibiotics,it is very important to reduce the resistance and to take effective measures to control its spread.更多还原