目的观察ICU患者肺部感染病原菌的分布及构成,研究头孢哌酮/舒巴坦对主要ICU肺部感染患者病原菌的抗菌活性,为临床治疗ICU肺部感染提供依据。方法选取医院2009-2012年ICU发生肺部感染病例152例,对送检标本进行细菌培养,选取主要病原菌对头孢哌酮/舒巴坦等10种抗菌药物进行药敏试验,药敏试验采用纸片扩散法;采用WHONET 5.5软件进行统计分析。结果共分离病原菌183株,其中革兰阴性菌120株占65.57%,革兰阳性菌45株占19.67%,真菌27株占14.75%;排前4位病原菌依次为鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌,分别占21.31%、17.49%、13.66%、10.38%;头孢哌酮/舒巴坦对鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌的敏感率分别为84.62%、90.32%、78.26%、89.47%,其中对鲍氏不动杆菌和铜绿假单胞菌的敏感性均明显高于其他9种抗菌药物,对于肺炎克雷伯菌和大肠埃希菌,仅次于亚胺培南和美罗培南。结论 ICU肺部感染以革兰阴性菌为主,头孢哌酮/舒巴坦为优选的治疗抗菌药物。
OBJECTIVE To observe the distribution and constituent ratios of the pathogenic bacteria causing pulmonary infections in the ICU patients and study the antibacterial activity of cefoperazone-sulbactam against the major species of pathogens causing pulmonary infections so as to provide guidance for the clinical treatment of pulmonary infections in ICU.METHODS From 2009 to 2012,totally 152cases of ICU patients with pulmonary infections were enrolled in the study,then the bacterial culture of submitted specimens was performed,the drug susceptibility testing for 10 antibiotics such as cefoperazone-sulbactam was performed with the use of disc diffusion method. RESULTS A total of 183strains of pathogens have been isolated,among which there were 120(65.57%)strains of gram-negative bacteria,45(19.67%)strains of gram-positive bacteria,and 27(14.75%)strains of fungi;the Acinetobacter baumannii(21.31%),Klebsiella pneumoniae(17.49%),Pseudomonas aeruginosa(13.66%),and Escherichia coli(10.38%)ranked the top 4species of pathogens.The drug susceptibility rates of the A.baumannii,K.pneumoniae,P.aeruginosa,and E.coli to cefoperazone-sulbactam were 84.62%,90.32%,78.26%,and 89.47%,respectively;the A.baumannii and P.aeruginosa were more susceptible to cefoperazone-sulbactam than to other nine antibiotics,while the K.pneumoniae and E.coli were less susceptible to cefoperazone-sulbactam than to imipenem and meropenem.CONCLUSION The gram-negative bacteria are the main pathogens causing the pulmonary infections in ICU,and cefoperazone-sulbactam is the preferred antibiotic.