重症监护病房感染病原菌分布及耐药性分析

调查医院重症监护病房（ICU）病原菌感染的分布及耐药趋势,为临床合理选用抗菌药物提供依据。本文对ICU患者病原菌采用自动微生物检定仪鉴定,K-B纸片扩散法进行药敏试验。结果表明,255株菌中,革兰氏阴性菌120株（占47.1%）,革兰氏阳性菌75株（占29.4%）,真菌60株（占23.5%）;革兰氏阴性菌中非发酵菌比例较高（占G-66.7%）,其中铜绿假单胞菌居首位（占43.0%）,其次是鲍曼不动杆菌（17.0%）;大肠埃希氏菌、肺炎克雷伯菌及阴沟肠杆菌共22株,占18.0%,其中产超广谱内酰胺酶（ESBLs）比率大于70.0%;革兰氏阳性菌以金黄色葡萄球菌为主,有29株,耐甲氧西林金黄色葡萄球菌（MRSA）26株,占89.7%;真菌60株,对5-氟胞嘧啶、两性霉素、氟康唑、伊曲康唑及氟利康唑均敏感。这说明ICU患者感染多耐药严重,加强耐药性监测、合理使用抗菌药物十分重要。

Distribution and Antibacterial Resistance of Pathogens in Intensive Care Unit

To study the tendency of bacterial distribution and drug resistance of pathogens in ICU and instruct clinical application of antibiotics reasonably,the bacteria isolated from patients in ICU were identified and antibiotic susceptibility was determined by K-B disk diffusion method.The results showed that the 120 Germ-negative bacteria,75 Gram-positive bacteria and 60 fungi in 255 isolated strains accounted for 47.1%,29.4% and 23.5% respectively.The most common strains of Gram-negative bacteria was pseudomonas aeruginosa （43.0%）, the second one was acinetobacter baumannii （ 17.0% ）. The Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae were 22 strains （ 18.0% ）. The rate of the ESBLs was more than 70.0%. The most common pathogens of Gram-positive bacteria were Staphylococci（29 strains）. Metieillin-resistant strains of Staphylococci aureus accounted for 89.7% （26 strains）. All the 60 strains fungi were sensitive to flucytosine, amphotericin B, fluconazole, itraconazole voriconazole. The infection and multi-drug resistance of pathogens was serious in ICU. It is important and urgent to carry out surveillance of bacterial resistance for appropriately use of antibiotics.