重症监护病房铜绿假单胞菌耐药性研究及其临床意义.docVIP

重症监护病房铜绿假单胞菌耐药性研究及其临床意义 　　[摘要] 目的 了解重症监护病房（ICU）病人铜绿假单胞菌（Pseudomonas aeruginosa，PA） 的耐药谱及其变化，为临床预防控制ICU感染及合理选择使用抗菌药物提供依据。 方法 采用回顾性方法对ICU三年送检的痰标本中分离的298株铜绿假单胞菌耐药性进行调查分析。 结果 ICU病房铜绿假单胞菌感染率为67.9%。药敏实验中以头孢吡肟和头孢他啶等抗生素的抗菌作用较强，而氨苄西林/舒巴坦钠、氧氟沙星、氨曲南、阿莫西林/克拉维酸、复方磺胺等抗生素的抗菌作用较差，耐药率均达到50%以上，显示PA单一耐药和多重耐药现象非常严重。 结论 ICU病房病人PA感染情况十分严重，对抗生素的耐药率有上升趋势，应及时进行PA耐药监测，指导临床合理选择抗菌药物。 　　[关键词] 铜绿假单胞菌；重症监护；耐药 　　[中图分类号] R446.5 [文献标识码] B [文章编号] 1673-9701（2011）36-106-02 　　 　　Prevalence of Pseudomonas Aeruginosa Infection of Patients in Intensive Care Unit （ICU） 　　YANG Suhua1 XIAO Qin1 WEN Xuezhuang1 YUAN Li2 CHEN Xiaoyi2 WANG Ping1 　　1.Cangnan County Healthcare Hospital for Women and Children, Wenzhou 325800, China; 2.The First Affiliated Hospital,Zhejiang University School of Medicine, Hangzhou 310006, China 　　 　　[Abstract] Objective To investigate the Pseudomonas aeruginosa（PA）drug resistance spectrum in intensive care unit（ICU）, for the clinical prevention of infection and provide the basic knowledge for selection of antibiotics. Methods A retrospective method was used for study the 298 of antibiotic resistance in PA isolated from sputum samples collected from patients in ICU ward. Results 67.9% of the patients in ICU were infected with PA. Sensitivity experiments showed Cefepime and ceftazidime have stronger antibacterial effect, but ampicillin/sulbactam, ofloxacin, aztreonam, amoxicillin/clavulanic acid, sulfamethoxazole are poor, indicating single drug and multiple drug resistance is very serious. Conclusion Pseudomonas aeruginosa infection in ICU patients is serious, and the rate of antibiotic resistance is increasing. Drug resistance should be performed to help the clinical selection of antibiotics. 　　[Key words] Pseudomonas aeruginosa；Intensive care unit；Drug resistance 　　重症监护病房（intensive care unit，ICU）是集现代化医疗护理技术为一体的病房或科室，把危重病人集中在这里，在人力、物力和技术上给予最佳保障，以期得到良好的救治效果。因此，ICU是医院的重点科室，ICU的医疗状况是医院综合实力的体现。然而，由于危重症患者的特殊生理、病理状况，ICU 中侵袭性操作以及广谱抗生素的使用等因素，使ICU 成为医院感染的高发区。导致ICU面临一个左右为难的局面：一方面广谱抗