Analysis of pathogens and drug-resistance of bacterial pneumonia in emergency intensive care unit
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摘要: 目的 分析急诊重症监护室细菌性肺炎患者病原菌分类及耐药情况，指导细菌性肺炎的抗感染策略。方法 选取2018年1月—2019年11月期间入住海军军医大学第三附属医院急诊重症监护室的161例痰培养阳性的细菌性肺炎病例，分析检出细菌的种类及药敏情况。结果 检出致病菌中以革兰阴性菌为主(80.9%)，菌群分布与同时间一些研究不尽相同。多重耐药菌常见，对于临床常用抗生素的耐药性较高。结论 急诊重症监护室细菌性肺炎患者培养菌株对于经验性抗感染治疗策略有一定的耐药性，了解所在病区的致病菌分类及耐药特点，有助于制订更有效的抗感染策略。Abstract: Objective To study and analyze pathogens and drug-resistance in patients with bacterial pneumonia in emergency intensive care unit (EICU), guiding the anti-infection strategy of bacterial pneumonia.Methods A total of 161 sputum culture-positive bacterial pneumonia patients admitted to the EICU of the Third Affiliated Hospital of Naval Medical University from January 2018 to November 2019 were selected to analyze pathogens and drug-resistance.Results Gram-negative bacteria (80.9%) were the main pathogenic bacteria. Multi-drug resistant organisms (MDRO) were common and had high resistance to commonly used antibiotics.Conclusion The pathogenic bacteria of the patients in the EICU bear certain resistance to empirical anti-infective treatment strategies. Understanding the classifications of pathogenic bacteria and the characteristics of drug-resistance is beneficial to develop a more effective anti-infection strategy.
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表 1 鲍曼不动杆菌药敏试验结果
% 抗生素名称 菌株/株 耐药率 中敏率 敏感率 米诺环素 78 29.5 29.5 41.0 替加环素 32 0 0 100.0 头孢曲松 79 93.7 6.3 0 庆大霉素 78 78.2 5.1 16.7 复方新诺明 79 58.2 2.5 39.2 头孢吡肟 79 91.1 3.8 5.1 左旋氧氟沙星 76 84.2 9.2 6.6 妥布霉素 79 77.2 2.5 20.3 头孢他啶 79 94.9 0 5.1 环丙沙星 79 94.9 0 5.1 亚胺培南 79 92.4 1.3 6.3 氨苄西林/舒巴坦 78 80.8 10.3 9.0 哌拉西林/他唑巴坦 78 94.9 0 5.1 阿米卡星 79 78.5 1.3 20.3 美罗培南 78 91.0 0 9.0 多黏菌素B 9 11.1 0 88.9 
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表 2 甲氧西林耐药金黄色葡萄球菌药敏试验结果
% 抗生素名称 菌株/株 耐药率 中敏率 敏感率 庆大霉素 23 26.1 17.4 56.5 复方新诺明 23 0 0 100.0 左旋氧氟沙星 23 82.6 0 17.4 环丙沙星 23 82.6 0 17.4 青霉素G 23 100.0 0 0 苯唑西林 23 100.0 0 0 莫西沙星 23 73.9 4.3 21.7 克林霉素 23 87.0 0 13.0 万古霉素 23 0 0 100.0 红霉素 23 91.3 0 8.7 利奈唑胺 23 0 0 100.0 利福平 23 4.3 0 95.7 四环素 23 78.3 0 21.7
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表 3 甲氧西林敏感金黄色葡萄球菌药敏试验结果
% 抗生素名称 菌株/株 耐药率 中敏率 敏感率 庆大霉素 7 0 0 100.0 复方新诺明 7 0 0 100.0 左旋氧氟沙星 7 0 0 100.0 环丙沙星 7 0 14.3 85.7 青霉素G 7 71.4 0 28.6 苯唑西林 7 0 0 100.0 莫西沙星 7 0 0 100.0 克林霉素 7 14.3 0 85.7 万古霉素 7 0 0 100.0 红霉素 6 16.7 0 83.3 利奈唑胺 7 0 0 100.0 利福平 7 0 0 100.0 四环素 7 14.3 0 85.7
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