重症监护室老年感染性疾病病原菌分布及耐药性分析

doi:10.19871/j.cnki.xfcrbzz.2021.02.005

新发传染病电子杂志 ›› 2021, Vol. 6 ›› Issue (2): 97-100.doi: 10.19871/j.cnki.xfcrbzz.2021.02.005

重症监护室老年感染性疾病病原菌分布及耐药性分析

梁庄万¹, 张群¹, 蒋秋燕¹, 杜利君²

1.资阳市人民医院检验科,四川资阳 641300;
2.南充市中心医院检验科,四川南充 637000

收稿日期:2021-01-15 出版日期:2021-05-31 发布日期:2021-06-24
通讯作者: 梁庄万,E-mail：1114956627@qq.com
基金资助:
南充地区检验危急值管理调查分析及其规范应用（18PJ123）

Distribution and drug resistance of pathogens with senile infectious diseases in intensive care unit

Liang Zhuangwan¹, Zhang Qun¹, Jiang Qiuyan¹, Du Lijun²

1. Department of Clinical Laboratory, Ziyang People's Hospital, Sichuan Ziyang 641300, China;
2. Department of Clinical Laboratory, Nanchong City Central Hospital, Sichuan Nanchong 637000, China

Received:2021-01-15 Online:2021-05-31 Published:2021-06-24

摘要/Abstract

摘要： 目的分析重症监护室老年感染性疾病病原菌分布及耐药性,提高临床控制重症监护室老年患者感染的水平。方法回顾性分析2016年1月至2018年12月在四川省资阳市人民医院重症监护室进行治疗的300例老年患者感染性疾病病原菌分布及耐药性。结果本研究共511份标本共分离出468株病原菌,病原菌主要来源于痰液（51.50%）,其次为血液（19.02%）、尿液（16.24%）、咽拭子（13.25%）;包含182株革兰氏阳性菌（38.89%）,232株革兰氏阴性菌（49.57%）,真菌54株（11.54%）;金黄色葡萄球菌、溶血葡萄球菌对青霉素、红霉素、庆大霉素等的耐药率较高;对万古霉素的耐药率最低。大肠埃希菌对哌拉西林、左氧氟沙星、复方新诺明具有较高的耐药性,耐药率均>60%。肺炎克雷伯菌对哌拉西林、头孢西丁、复方新诺明均有较高耐药率,耐药率>60%。鲍曼不动杆菌对多黏菌素E敏感,对其他被检抗菌药物的耐药率均较高。白假丝酵母菌对伏立康唑、5-氟胞嘧啶、氟康唑、伊曲康唑的耐药性均较低;热带假丝酵母菌仅对5-氟胞嘧啶的耐药率较低。结论本院重症监护室感染的主要病原菌多为条件致病菌,以革兰氏阴性菌为主,耐药情况严重,临床应定期检测病原菌分布及耐药情况,为合理应用抗菌药物提供依据。

关键词: 重症监护室, 感染性疾病, 病原菌, 耐药性

Abstract: Objective To analyze the distribution and drug resistance of pathogens in elderly patients with infectious diseases in intensive care unit (ICU), and to improve the clinical control of infection in senile patients in ICU. Methods The pathogen distribution and drug resistance of 300 senile patients with infectious diseases treated in the intensive care unit of Ziyang people's Hospital from January 2016 to December 2018 were retrospectively analyzed. Results A total of 511 specimens were isolated from a total of 468 pathogenic strains, which mainly originated from sputum (51.50%), followed by blood (19.02%), urine (16.24%), and pharyngeal swabs (13.25%), which contained 182 Glan-positive strains (38.89%), 232 Glan-negative strains ( 49.57%), and 54 strains of fungi (11.54%). Staphylococcus aureus and Staphylococcus hemolyticus showed high resistance to penicillin, erythromycin, and gentamicin; resistance to vancomycin was the lowest. Escherichia coli were highly resistant to piperacillin, levofloxacin, and cotrimoxazole, with resistance rates >60%. Klebsiella pneumoniae is highly resistant to piperacillin, cefoxitin, and cotrimoxazole, with a resistance rate of >60%. Acinetobacter baumannii is sensitive to polymyxin E and has a high resistance rate to other antibiotics. Candida albicans was less resistant to voriconazole, 5-fluorocytosine, fluconazole and itraconazole, while Candida tropicalis was less resistant to 5-fluorocytosine. Conclusions The main pathogens of ICU infection in our hospital are conditional pathogens, mainly Gram-negative bacteria, and the drug resistance is serious. The distribution and drug resistance of pathogens should be detected regularly in clinic to provide basis for rational use of antibiotics.

Key words: Intensive care unit, Infectious diseases, Pathogens, Drug resistance

梁庄万, 张群, 蒋秋燕, 杜利君. 重症监护室老年感染性疾病病原菌分布及耐药性分析[J]. 新发传染病电子杂志, 2021, 6(2): 97-100.

Liang Zhuangwan, Zhang Qun, Jiang Qiuyan, Du Lijun. Distribution and drug resistance of pathogens with senile infectious diseases in intensive care unit[J]. Electronic Journal of Emerging Infectious Diseases, 2021, 6(2): 97-100.

参考文献

[1] 许英, 黄兵, 杨洁, 等.重症监护室多重耐药菌感染的临床药学监护[J]. 上海医药, 2019, 40(3):49-51.
[2] 谢红, 江帆, 陈霞. 2015-2017年德阳市人民医院重症监护室感染病原菌分布及耐药性分析[J].现代药物与临床, 2019, 34(3):853-857.
[3] 中华人民共和国卫生部. 医院感染诊断标准(试行)[J]. 中华医学杂志, 2001, 81(5):314-320.
[4] 叶应妩, 王毓三, 申子瑜. 全国临床检验操作规程[M]. 3版. 南京: 东南大学出版社, 2006:744-745.
[5] 刘长爱. 重症监护室医院感染的影响因素与预防对策[J]. 中国保健营养, 2019, 29(8):264-265.
[6] 陈映, 李阳, 张娆, 等. 三例多重耐药鲍曼不动杆菌引起医院聚集性感染[J/CD]. 中华实验和临床感染病杂志(电子版), 2019, 13(3):260-263.
[7] 张楠, 李琦, 潘丽萍, 等. 结核重症监护室真菌感染的危险因素分析[J]. 中国医药导报, 2019, 16(1):74-76,81.
[8] LIU X, ZOU N, ZHU D, et al.Influencing factors analysis and modeling of hospital-acquired infection in elderly patients[J]. J Comb Optim, 2019, 37(4):248-270.
[9] 吴晓燕. 重症监护室院内感染原因分析及护理分析[J]. 中国农村卫生, 2019, 11(1):46-47.
[10] SILVA ACSE, SOUSA DSC, PERRAUD EBC, et al. Pharmacotherapeutic follow-up in a respiratory intensivecare unit: description and analysis of results [J]. Einstein(Sao Paulo), 2018,16(2):eAO4112
[11] 谢俊杰, 孙恒彪, 潘祖汉, 等. 1245株金黄色葡萄球菌临床感染分布及耐药性变迁[J/CD]. 中华实验和临床感染病杂志:电子版, 2018, 12(1):89-93.
[12] SEIL WH, WUNDERINK RG, WILLIAMS DJ, et al.Update in adult community-acquired pneumonia: key points from the new American Thoracic Society/Infectious Diseases Society of America 2019 guideline[J]. Curr Opin Pulm Med, 2020, 26(3):203-207.
[13] 阿布都卡哈尔•阿布都热孜克, 马依努尔•阿布都克力木. 神经外科重症监护室医院感染危险因素分析及预防措施[J]. 中国保健营养, 2019, 29(15):101.
[14] MALLOW C, ISAKOW W.Risk factors for loss of lung sliding in a medical intensive care population with acute respiratory failure[J]. J Bronchol Interv Pulmonol, 2019, 26(2):102-107.
[15] 吴军华, 阮培森, 宋启发, 等. 儿童重症监护病房产超广谱β-内酰胺酶大肠埃希菌耐药性分析[J]. 中国消毒学杂志, 2018, 35(4):34-37.
[16] HOZZARI A, BEHZADI P, KHIABANI PK, et al.Clinical cases, drug resistance, and virulence genes profiling in Uropathogenic Escherichia coli[J]. J Appl Genet, 2020, 61(2):265-273.
[17] Clinical and Laboratory Standards Institute (CLSI).Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Fourth Informational Supplement[S].2014: M100-S24.
[18] ANCONA P, BAILEY M, BELLOMO R.Characteristics,incidence and outcome of patients admitted to intensive care unit with Guillain-Barre syndrome in Australia and New Zealand[J]. J Crit Care, 2018,45:58-64.
[19] GRAINHA TRR, JORGE PADS, PéREZ-PéREZ M, et al.Exploring anti-quorum sensing and anti-virulence based strategies to fight Candida albicans infections: an in silico approach[J]. FEMS Yeast Res, 2018, 18(3): foy022.
[20] JOãO NAJR, CAMPOS SV, THOMAZ DY, et al. Candida blankii: an emergent opportunistic yeast with reduced susceptibility to antifungals[J]. Emerging Microbes & Infections, 2018, 7(24):1-3.
[21] 汪洋, 梅艳, 李思婵, 等. 应用蒙特卡洛模拟探索不同CYP2C19基因型侵袭性真菌感染患者的伏立康唑最佳用药方案[J]. 中国医院药学杂志, 2018, 38(1):1-4.
[22] 汪倩钰, 李从荣, 郭静. 武汉某院住院患者无菌体液真菌感染临床分布及耐药性分析[J]. 检验医学, 2019,34(7):591-594.
[23] 张桂萍. 重症监护室患者行气管切开术后并肺部感染的护理效果评价[J]. 中国保健营养, 2019, 13(15):309.
[24] 彭博, 鹿英英, 吴珺, 等. 2014—2016 年北京丰台医院ICU感染的病原菌分布及耐药性分析[J]. 现代药物与临床, 2017, 32(11):2272-2276.
[25] 王思苑, 孙丽琴, 段司沁, 等. CD4/CD8比值在HIV感染者中临床分析及其预测价值[J/CD]. 新发传染病电子杂志, 2019, 4(2): 91-96.
[26] 毛旖川, 朱静芬, 李勇刚. 多重耐药肺炎克雷伯杆菌肺部感染临床与CT特征[J/CD]. 新发传染病电子杂志, 2018, 3(4):206-209.
[27] 王慧君, 何逸清, 林少明, 等.医院获得性假丝酵母菌菌血症流行病学特征及其药物敏感性[J].中国感染控制杂志, 2020, 19(1):7-13.

重症监护室老年感染性疾病病原菌分布及耐药性分析

Distribution and drug resistance of pathogens with senile infectious diseases in intensive care unit

PDF

可视化

摘要/Abstract

引用本文

使用本文

参考文献

相关文章 3

编辑推荐

Metrics

本文评价

[1]	张淑贞, 李雪宏, 黄海燕, 陈海婷, 王湘雨, Barry Marshall, Alfred Tay. 深圳地区幽门螺杆菌临床分离菌株的耐药性分析[J]. 新发传染病电子杂志, 2021, 6(2): 79-83.
[2]	吕昆来, 辛小娟, 李春华. 548例发热待查患者病因分析[J]. 新发传染病电子杂志, 2020, 5(4): 258-261.
[3]	毛旖川, 朱静芬, 李勇刚. 多重耐药肺炎克雷伯杆菌肺部感染临床与CT特征[J]. 新发传染病电子杂志, 2018, 3(4): 206-209.