呼吸重症监护病房中G+

    球菌分离率及耐药调查

    梁国庆1

    , 张 杰2

    , 王 辰2

    , 张洪玉2

    , 翁心植2

    (1. 阳江市人民医院, 广东 阳江 529500; 2. 北京首都医科大学附属朝阳医院, 北京 100020)

    摘要: 目的 分析及探讨近年来呼吸重症监护病房(R ICU )收治患者的G+

    球菌的分离率及耐药情况。方法 选

    择近 3 年我院R ICU 收治的有完整细菌学资料的患者进行统计分析。结果 革兰阳性球菌的分离率 1996 年为

    18. 75%、 1997 年为 28. 21%、 1998 年则增至 48. 75% , 3 年之间相比均有非常显著的差异; 主要为表皮葡萄球菌、金黄色葡萄球菌及肠球菌等; 除对万古霉素保持敏感外, 对其他的抗生素均有很高的耐药率。结论 合理使用及

    严格限定抗生素的应用指征对延缓细菌耐药性的产生以及个别多重耐药菌的传播与流行至关重要。

    关键词: 革兰阳性球菌; 呼吸重症监护病房; 分离率; 耐药

    中图分类号: R563 文献标识码: A 文章编号: 100524529 (2001) 0320166203

    Invest iga t ion of Isola ted Ra te and Drug Res istance of Gram

    -pos it ive Cocc i in the Resp ira tory In ten s ive Care Un it

    L IAN G Guo2 qing, ZHAN G J ie, WAN G Chen, ZHAN G Hong2 yu, W EN G Xing2 zh i

    (D ep a rtm en t of R esp ira tory D iseases, B eij ing R ed C ross Chaoy ang H osp ita l,Cap ita lM ed ica l U n iversity , B eij ing 100020)

    Abstract : OBJECTIVE To study iso lated rate and ant im icrobial resistance of gram 2 po sit ive cocci in the

    resp irato ry intensive care unit (R ICU ) in recent years . METHODS The bacter io logical data of the pat ient adm it ted

    in R ICU in the recent th ree years w ere selected and analyzed . RESULTS The iso lated rate of gram 2 po sit ive cocci

    w as increasing surp r isingly, and w as 18. 75% in 1996, 28. 21% in 1997 and 48. 75% in 1998. There w as a

    signif icant difference betw een each year . The iso lated gram 2 po sit ive cocci w ere mainly the S tap hy lococcus

    ep id erm id is, S. au reus and enterococci etc . The ant im icrobial resistance of these cocciw as very ser ious . A nd the

    iso lated cocci had very h igh drug2resistance rate fo r the all ant ibio t ics excep t fo r vancomycin . CONCLUSIONS

    There w as m isuse and overuse in the ant ibio t ics fo r gram 2 negat ive bacilli, especially fo r the 3rd generat ion

    cephalo spo r ins and quino lones, thus the gram 2 po sit ive cocci of the h igh ant im icrobial resistance w ere selected .

    Then it w as diff icult fo r the fur ther ant im icrobial t reatment, even no ant ibio t ics could be selected somet imes and

    induced h igh mo r tality of the pat ients . It is very impo r tant to use ant ibio t ics and cont ro l the indicat ion of select ing

    ant ibio t ics fo r slow ing the p roduct ion of ant im icrobial resistance of the bacter ia and the sp read of some

    mult idrug2resistant o rganism s .

    Key words : Gram2 po sit ive cocci ; R ICU ; Iso lated rate of bacter ia; A nt im icrobial resistance of bacter ia

    近年来, 我们在工作中发现 G+

    球菌的出现频

    率越来越高, 这种现象在呼吸重症监护病房表现更

    为突出, 为进一步证实这一变化及分析其原因, 我们

    因顾了近 3 年来我院呼吸重症监护病房(R ICU )收

    治患者的细菌学资料, 并针对 G+

    球菌的分离率及

    耐药情况进行了分析及探讨。

    1 资料与方法

    1 . 1 病例资料 选择 1996 年 1 月～ 1998 年 12 月

    我院呼吸重症监护病房(R ICU )收治的有完整细菌

    学资料的患者1 2 3例, 其中男性9 6例, 平均年龄

    收稿日期: 2000204207; 修订日期: 2000212221

    6 6. 4 3±1 2. 5岁; 女性2 7例, 平均年龄5 9. 7 4±

    16. 76 岁 ......