重症监护病房细菌耐药性监测

目的 为危重患者抗感染提供治疗依据，防止耐药菌的传播。方法 从2000年1月～2001年12月，每天收集细菌室对重症监护病房的各类标本的分离菌鉴定药敏资料，定期对细菌及抗菌药物进行分类与统计并反馈给病房。结果 共分离出1105株，以革兰阴性菌为主，占52．6％，革兰阳性菌占28．2％，真菌占19．2％；耐甲氧西林金黄色葡萄球菌与耐甲氧西林凝固酶阴性葡萄球菌的发生率分别为79．6％、85．7％；大肠埃希菌和克冒伯菌产超广谱β-内酰胺酶率分别为37％和29％；大肠埃希菌对环丙沙星的耐药率高，达76．1％；铜绿假单胞菌对头孢他啶和亚胺培南的耐药率分别为37．8％、29．6％。结论 加强重点部门细菌耐药性监测与反馈，可使抗菌药物在重症感染患者中发挥重要作用，防止耐药菌的播散。

Surveillance of Antibiotic-resistance of Bacteria Isolated from ICU

OBJECTIVE To investigate the resistance of bacteria isolated from ICU as a reference for rational use of antibiotics and prevent the resistant bacteria from spreading in ICU. METHODS Bacteria were collected from ICU everyday for bacterial susceptibility tests during Jan 2000 Dec 2001 and ICU were informed of the results timely. RESULTS In 1 105 strains isolated from ICU, the percentage of Gram negative bacilli, Gram positive bacteria and fungi were 52.6%, 28.2% and 19.2%, respectively. Among them Staphylococcus aureus (SA) and coagulase negative staphylococci (CNS), meticillin resistant SA (MRSA) and meticillin resistant CNS (MRCNS) accounted for 79.6% and 85.7%, respectively. Escherichia coli and Klebsiella pneumoniae producing ESBLs accounted for 37% and 29.0%, respectively. The drug resistance rate of E. coli to ciprofloxacin was high which was 76.1%. The drug resistance rate of Pseudomonas aeruginosa to ceftazidime and imipenem were 37.8% and 29.6%, respectively. CONCLUSIONS It is important to investigate and put feedback information of resistant bacteria in ICU in order to prevent them from spreading and supply reference for rational use of antibiotics in clinic.