目的 探討呼吸重癥監(jiān)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(diào)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(jié)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(shù)、應(yīng)用碳青霉烯類抗生素、機械通氣時間、留置導(dǎo)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(jié)論 RICU 多重耐藥菌感染發(fā)生率高?；颊呷胱ICU次數(shù)、應(yīng)用碳青霉烯類抗生素、機械通氣時間、留置導(dǎo)尿時間及合并糖尿病與患者發(fā)生多重耐藥菌感染有密切關(guān)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(jiān)護雜志, 2010, 9(1): 19-22. doi: 復(fù)制
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- 1. 王東浩,王偉,王勇強,等.重癥監(jiān)護病房獲得性細菌感染臨床調(diào)查.中華醫(yī)院感染學(xué)雜志,2004,14:151-153.
- 2. 鞏志業(yè),溫寧,王樞群.多重耐藥及其控制.中國公共衛(wèi)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(jiān)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(xué),王春雷,李艷玲,等.169例非發(fā)酵革蘭陰性桿菌所致院內(nèi)獲得性肺炎的危險因素及耐藥性分析.中國血液流變學(xué)雜志,2007,17:290-292.