ICU尿培养阳性标本的致病菌分布及耐药性分析(1)
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[摘要] 目的 了解ICU患者尿培养阳性标本的致病菌感染分布及耐药状况，为临床合理用药提供依据。 方法 回顾性分析2009～2011年湖北医药学院附属人民医院ICU患者尿标本中分离的致病菌分布及耐药状况，用Whonet 5.5软件进行分析。 结果 分离菌株207株，其中，假丝酵母菌99株，革兰阴性杆菌72株，革兰阳性球菌36株，分别占阳性例数的47.83%、34.78%和17.39%；三类致病菌分别对特比萘芬、喹诺酮类及头孢菌素类抗菌药物表现出较高的耐药率。 结论 ICU患者尿培养假丝酵母菌感染率高，致病菌耐药现象严重。应加强ICU尿培养的监测，预防假丝酵母菌感染。
[关键词] 尿培养；ICU；假丝酵母菌感染；耐药性
[中图分类号] R181.34 [文献标识码] A [文章编号] 1673-7210(2012)01(b)-104-02
Distribution and drug resistance of pathogens from urine culture positive specimens in ICU
GUO Liang1 ZHENG Weidong1 TIAN Yan2▲
1.Department of Clinical Laboratory, the Affiliated People′s Hospital of Hubei University of Medicine, Hubei Province, Shiyan 442000, China; 2.Huaguo Hospital of Zhangwan District in Shiyan City, Hubei Province, Shiyan 442003, China
[Abstract] Objective To understand the distribution and drug resistance of pathogens from the positive urine culture specimens in ICU patients, and provide the basis for the clinical use of drugs. Methods The distribution and drug resistance of pathogens from the positive urine culture specimens in ICU patients of the Affiliated People's Hospital of Hubei University of Medicine were retrospectively analyzed with software Whonet 5.5. Results Among 207 isolated strains pathogens, including 99 Candida, 72 Gram-negative bacterias, 36 Gram-positive bacterias, the rates were 47.83%, 34.78% and 17.39%. Three pathogens had a higher resistance rates, respectively to Terbinafine, Couinaud ketone and Cephalosporin antibacterial drugs. Conclusion The rate of Candida infections in ICU patients is higher, drug-resistant phenomenon is serious. Urine culture monitoring should be strengthened in order to prevent Candida infections.
[Key words] Urine culture; ICU; Candida infections; Drug resistance
ICU作为医院的特殊病室，患者有自身的特殊性：病情重、病程较长、身体抵抗力差、免疫功能低下、侵入性操作多及因治疗需要用药周期长，导致细菌耐药性增加，是院内感染的主要病区。本文对湖北医药学院附属人民医院ICU尿培养感染的致病菌分布及耐药状况进行分析，旨在为临床用药提供依据。
1 材料与方法
1.1 材料
对2009年5月～2011年5月湖北医药学院附属人民医院ICU患者尿培养阳性标本的病原菌进行统计，共207株。
1.2 质控菌株
白色念珠菌(ATCC90028)、大肠埃希菌(ATCC25922)、金黄色葡萄球菌(ATCC25923)作为室内质控(均由卫生部临床中心提供)，每周做1次。
1.3 结果判定方法
细菌药敏试验采用K-B纸片扩散法，依据CLSI 2009～2010年版[1]标准判读。假丝酵母菌药敏试验采用Rosco药敏纸片扩散法。
2 结果
2.1 ICU患者尿液培养致病菌分布 ......
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