ICU新病房对细菌菌谱变迁及耐药性的影响

祁慧; 刘洋; 许莹; 顾勤

doi:10.13201/j.issn.1009-5918.2020.03.011

ICU新病房对细菌菌谱变迁及耐药性的影响

- 南京大学医学院附属鼓楼医院重症医学科(南京, 210000)
基金项目:
国家自然科学青年基金项目(No:81801950)

详细信息

通讯作者: 顾勤,E-mail:icuguqin@sina.com

中图分类号: R446.5

收稿日期: 2019-12-12

Effect of ICU new ward on bacterial spectrum changes and drug resistance

- Department of Intensive Medicine, Nanjing Drum-Tower Hospital, the Affiliated Hospital of Nanjing University Medical School, Nanjing, 210000, China

More Information

Corresponding author: GU Qin, E-mail: icuguqin@sina.com

Received Date: 12 December 2019

摘要

摘要: 目的:探讨病房环境对ICU病房病原菌种类分布及耐药性的影响。方法:统计南京鼓楼医院2012-03-2013-03期间收住ICU老病房的所有送检标本以及2013-03-2014-03期间收住ICU新病房的所有送检标本,剔除同一患者同一标本中的重复菌株,对入选标本进行比较。结果:2012-03-2013-03期间ICU老病房送检标本共计8 700份,剔除同一患者同一标本中的重复菌株5 655份,共有3 045份纳入研究对象,其中标本总体阳性率38.98%,阴性率61.02%,G+菌检出率为29.40%,G-菌检出率为59.22%,真菌检出率为11.37%;2013-03-2014-03期间ICU新病房送检标本共计7 919份,剔除同一患者同一标本中的重复菌株4 572份,共有3 347份纳入研究对象,其中总体标本阳性率29.01%,阴性率70.99%,其中G+菌检出率为31.82%,G-菌检出率为55.10%,真菌检出率为13.08%,新老病房中鲍曼不动杆菌检出率均最高,大肠埃希菌和肺炎克伯雷菌分别排列第2、第3位;表皮葡萄球菌在新病房中检出率增加,而金黄色葡萄球菌相比老病区检出率下降。结论:ICU新病房送检标本总体阳性率明显低于老病房,其中以G-菌检出率下降为主,但G+菌、真菌检出率较老病房有增加趋势,病原菌菌谱出现较大变迁可能与病房搬迁后环境改变、设备更新等有关。
- 病原菌 /
- 耐药性 /
- ICU病房
Abstract: Objective:To investigate the effects of ward environments on the distribution and drug resistance of hospital pathogens in ICU patients. Method:The retrospective study was undertaken at Nanjing Drum-Tower Hospital, the samples collected from the old ICU ward and the new ICU warda from March 2012 to March 2013 and March 2013 to March 2014 were included. Duplicate strains from the same specimen of the same patient were removed and the selected specimens were compared. Result:From March 2012 to March 2013, a total of 8700 samples were collected from the old ICU ward, and 5, 655 duplicate strains from the same patient were excluded. A total of 3, 045 were included in the study. The overall positive rate of the specimen was 38.98%, and the negative rate was 61.02%, Gram-positive bacteria detection rate was 29.40%, Gram-negative bacteria detection rate was 59.22%, fungus detection rate was 11.37%. From March 2013 to March 2014, the new ward sent a total of 7919 samples, excluding 4, 572 repetitive strains from the same specimen of the same patient, and a total of 3347 subjects were included in the study. The positive result was 29.01%, and the negative rate was 70.99%. Gram-positive bacteria detection rate was 31.82%, and Gram-negative bacteria detection rate was 55.10%. The detection rate of fungi was 13.08%. The detection rate of Acinetobacter baumannii was the highest in the new and old wards. The Escherichia coli and K. pneumoniae were ranked second and third respectively. The detection rate of the Staphylococcus epidermidis increased in the new ward. The detection rate of Staphylococcus aureus was lower than that in the old ward.Conclusion:The positive rate of all specimens in the ICU new ward is significantly lower than that of the old ward. The detection rate of Gram-positive bacteria is mainly decreased, but the detection rate of Gram-positive bacteria and fungi is higher than that of the old ward, and the pathogen spectrum is greatly changed. It may be related to environmental changes and equipment renewal after the ward is moved.
- pathogen /
- drug resistance /
- ICU ward

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