潘晓艳

[摘要] 目的 分析526株重症医学科（ICU）主要革兰氏阴性杆菌耐药性，以便更好的为重症患者进行有效治疗。方法 对2014年1—12月在该院ICU分离出的526株革兰氏阴性菌为研究对象，分析其菌株种类及所占比例，并进行药物敏感度实验，分析其对常用药物的耐药率。结果 共检出革兰氏阴性杆菌2 818株，其中ICU检出526株，且以肺炎克莱伯菌及大肠埃希菌为主。大肠杆菌、肺炎克雷菌及鲍曼不动杆菌对复方新诺明耐药率较高，分别为74.95%、41.72%及54.51%。5种菌株对左氧氟沙星、头孢他啶均有一定耐药性。 结论 ICU中革兰氏阴性菌种类较多，应对各菌株耐药性进行监测分析，应根据各菌株不同情况给予相应药物进行治疗。

[关键词] 重症医学科；革兰氏阴性杆；耐药性

[中图分类号] R5 [文献标识码] A [文章编号] 1674-0742（2016）03（c）-0177-02

Drug Resistance Analysis of 526 Strains Main Gram-Negative Bacilli in ICU

PAN Xiao-yan

Department of Clinical Laboratory and Microbiology Laboratory， Datong Third Hospital， Datong，Shanxi Province，037006 China

[Abstract] Objective To analyze the drug resistance of 526 strains main gram-negative bacilli in ICU in order to better and effectively treat the severe patients. Methods 526 strains gram-negative bacilli separated from the ICU of our hospital from January 2014 to December 2014 were selected as the research object， the strain types and proportions were analyzed， and the drug resistance rates of them to common drugs were analyzed by the drug sensitivity experiment. Results 2 818 strains gram-negative bacilli were detected in total， among them， 526 strains （mainly klebsiella pneumoniae and escherichia coli） were detected by ICU， the drug resistance rates of bacillus coli， klebsiella neumoniae and acinetobacter baumanii to bactrim were higher （74.95%， 41.72%， 54.51%）， and the five strains had a certain drug resistance to levofloxacin and ceftazidime. Conclusion The gram-negative bacillus type is more in ICU， we should monitor and analyze the drug resistance of different strains and give the corresponding drug treatment according to the different conditions of different strains.

[Key words] ICU； Gram-Negative bacillus； Drug resistance

ICU作为医院对危重患者进行治疗及观察地点，使患者暴露于多种病菌共存的环境中，且由于患者病情危重，免疫力低下[1]，且由于治疗的必要性，多数患者采用气管插管或留置导管治疗[2]，更增加了感染的可能性，导致其院内感染发生率较高。有学者通过研究指出[3]，ICU病房中大部分细菌为革兰氏阴性杆菌，且对其具体病菌种类进行分析并采用相应抗菌药物可有效降低其感染率，该研究对象为2014年1—12月在该院ICU分离出的526株革兰氏阴性菌的种类及耐药性进行分析，以减少其感染事件，现报道如下。

1 资料与方法

1.1 一般资料

以2014年1—12月在该院ICU分离出的526株革兰氏阴性菌为研究对象，其来源主要为：呼……