Analysis of pathogenic bacteria distribution and drug resistance monitoring in ICU patients' sputum cultures
ICU患者痰培养病原菌分布及耐药性监测分析

摘要

目的 探究ICU患者痰培养病原菌分布及监测耐药性。方法 2024年1月-2024年12月，取我院ICU重症肺炎患者127例，127例患者均行痰液培养，采用迪尔D2 mini细菌鉴定仪分析病原学特征，通过鉴定药敏一体卡探究药敏结果。结果 127例患者中检出238株病原菌，其中186株革兰阴性菌（78.15%）、52株革兰阳性菌（21.85%）。分析可见，鲍曼不动杆菌耐药率最高的是头孢唑林，达51.43%；耐受亚胺培南几率较低；铜绿假单胞菌耐受头孢唑林几率最高，达100.00%，对甲氧苄啶/磺胺、氨苄西林/舒巴坦无耐药；肺炎克雷伯菌耐受甲氧苄啶/磺胺、氨苄西林/舒巴坦、头孢唑林几率较高。金黄色葡萄球菌耐受红霉素性能较高，达60.87%。结论 ICU重症肺炎患者抗菌药物选择时，还需强化管理，采用的迪尔D2 mini细菌鉴定仪及MIC法药敏检测结果合理科学给药，减少产生耐药菌株，疗效提升。

Abstract

Objective To explore the distribution of pathogenic bacteria in sputum cultures and the monitoring of drug resistance in ICU patients.
Methods From January 2024 to December 2024, 127 patients with severe pneumonia in our ICU were selected. All 127 patients underwent sputum culture. The pathogenic characteristics were analyzed using the Diir D2 mini bacterial identification instrument. The drug sensitivity results were explored using the identification card for drug sensitivity (the drug sensitivity test used the MIC method, and this drug sensitivity card did not contain aztreonam or cefotaxime).
Results Among the 127 patients, 238 pathogenic bacteria were detected, including 186 Gram-negative bacteria (78.15%) and 52 Gram-positive bacteria (21.85%). Analysis showed that the resistance rate of Acinetobacter baumannii was the highest to cefazolin, reaching 51.43%; the probability of tolerance to imipenem was relatively low; the resistance rate of Pseudomonas aeruginosa to cefazolin was the highest, reaching 100.00%, and it had no resistance to trimethoprim/ sulfamethoxazole or ampicillin/sulbactam; the resistance rate of Klebsiella pneumoniae to trimethoprim/ sulfamethoxazole, ampicillin/sulbactam, and cefazolin was relatively high. The resistance performance of Staphylococcus aureus to erythromycin was relatively high, reaching 60.87%.
Conclusion   When selecting antibiotics for ICU patients with severe pneumonia, it is necessary to strengthen management. The use of the Diir D2 mini bacterial identification instrument and the MIC method for drug sensitivity testing (the drug sensitivity card does not contain aztreonam or cefotaxime) is reasonable and scientific, reducing the occurrence of drug-resistant strains and improving the therapeutic effect.