RICU 多重耐藥菌的耐藥及危險因素分析_《中國呼吸與危重監護雜志》

作者：

楊慧 , 向平超 , 郭偉安 , 孫佳 , 宋麗萍 , 張碩

北京大學首鋼醫院呼吸與危重癥醫學科（北京 100144）通訊作者: 向平超, E-mail: xpcemail@ sohu. com;

關鍵詞：

呼吸重癥監護病房多重耐藥菌泛耐藥菌危險因素

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目的探討呼吸重癥監護病房( RICU) 多重耐藥菌的分布特點、耐藥情況, 以及多重耐藥菌感染的危險因素。方法采用回顧性調查的方法, 對2008 年4 月至2009 年5 月收住RICU的79例患者的病原菌進行分析。同時在非多重耐藥、多重耐藥及泛耐藥三組患者之間進行多重耐藥菌危險因素分析。結果分離出的129 株病原菌中前三位分別為銅綠假單胞菌( 24. 0% ) 、金黃色葡萄球菌( 22. 5% ) 及鮑曼不動桿菌( 15. 5% ) ; 多重耐藥菌72 株, 前三位分別為金黃色葡萄球菌( 38. 9% ) 、銅綠假單胞菌( 25. 0% ) 及鮑曼不動桿菌( 19. 4% ) 。泛耐藥菌29 株, 以銅綠假單胞菌( 48. 3% ) 及鮑曼不動桿菌( 44. 8% ) 為主。多因素Logistics 回歸分析顯示入住RICU次數、應用碳青霉烯類抗生素、機械通氣時間、留置導尿時間及合并糖尿病為多重耐藥菌感染的獨立危險因素。結論 RICU 多重耐藥菌感染發生率高。患者入住RICU次數、應用碳青霉烯類抗生素、機械通氣時間、留置導尿時間及合并糖尿病與患者發生多重耐藥菌感染有密切關系。

引用本文： 楊慧,向平超,郭偉安,孫佳,宋麗萍,張碩. RICU 多重耐藥菌的耐藥及危險因素分析. 中國呼吸與危重監護雜志, 2010, 9(1): 19-22. doi: 復制

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13.	戚其學,王春雷,李艷玲,等.169例非發酵革蘭陰性桿菌所致院內獲得性肺炎的危險因素及耐藥性分析.中國血液流變學雜志,2007,17:290-292.

1. 王東浩,王偉,王勇強,等.重癥監護病房獲得性細菌感染臨床調查.中華醫院感染學雜志,2004,14:151-153.
2. 鞏志業,溫寧,王樞群.多重耐藥及其控制.中國公共衛生,2002,18:1022-1023.
3. Falagas ME, Koletsi PK,Bliziotis IA.The diversity of definitions of multidrug-resistant (MDR) and pandrug-resistant (PDR) Acinetobacter baumannii and Pseudomonas aeruginosa.J Med Microbiol,2006,55:1619-1629.
4. McGowan JE Jr.Resistance in nonfermenting gram-negative bacteria: multidrug resistance to the maximum.Am J Med,2006,119:S29-S36.
5. Quinn jP.Clinical problems posed by multiresistant nonfermenting gram-negative pathogens.Clin Infect Dis,1998,27:S117-S124.
6. Tenover FC.Novel and emerging mechanisms of antimicrobial resistance in nosocomial pathogens. Am J Med,1991,91:76S-81S.
7. Smith SM,Eng RK,Tecson-Tumany F.Ciprofloxacin therapy for methicillin-resistant Staphylococcus aureus infections or colonizations. Antimicrob Agents Chemother,1989,33:181-184.
8. 俞森洋.常見感染致病菌的耐藥機制及防治對策.中國呼吸與危重監護雜志,2002,2:71-75.
9. Du B, Chen D,Liu D,et al.Restriction of third-generation cephalosporin use decreases infection-related mortality.Crit Care Med,2003,31:1088-1093.
10. Rice LB, Willey SH, Papanicolaou GA, et al.Outbreak of ceftazidime resistance caused by extended-spectrum beta-lactamases at a Massachusetts chronic-care facility.Antimicrob Agents Chemother,1990,34:2193-2199.
11. Wallace MR, Johnson AP, Daniel M,et al.Sequential emergence of multi-resistant Klebsiella pneumoniae in Bahrain.J Hosp Infect,1995,31:247-252.
12. Dzidic S, Bedekovi? V.Horizontal gene transfer-emerging multidrug resistance in hospital bacteria. Acta Pharmacol Sin,2003,24:519-26.
13. 戚其學,王春雷,李艷玲,等.169例非發酵革蘭陰性桿菌所致院內獲得性肺炎的危險因素及耐藥性分析.中國血液流變學雜志,2007,17:290-292.

《中國呼吸與危重監護雜志》

RICU 多重耐藥菌的耐藥及危險因素分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

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《中國呼吸與危重監護雜志》

RICU 多重耐藥菌的耐藥及危險因素分析

摘要 全文 圖表 視頻 參考文獻 施引文獻 補充材料

Format

Content

摘要全文圖表視頻參考文獻施引文獻補充材料