重症监护室6400例血培养病原菌分布及药敏分析

目的对重症监护室6400例血培养的病原菌进行分离，并对菌株的分布及药敏进行分析。方法回顾调查2011年1月至2013年6月高州市人民医院ICU病房6400例患者的血样标本，并对其病原菌种类进行分离。采用BDBACTECTM9120全自动血培养仪对血液进行培养，BD—Phoenix-100全自动细菌鉴定仪对细菌的种类进行鉴定并对细菌的药敏性进行检测。结果6400例血样中共检出细菌971株，阳性率为15．17％。其中革兰阴性菌检出515株，占53．04％；革兰阳性菌425株，占43．77％；真菌31株，占3．19％。检出病原菌主要为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌、表皮葡萄球菌、肺炎克雷伯菌以及肠球菌等。其中，葡萄球菌对于甲氧西林和青霉素的耐药性最大，大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌对亚胺培南都有很好的受药性。结论阴性葡萄球菌、鲍曼不动杆菌等在重症监护室中属于多发常见的病原菌，该种菌的耐药性以及多重耐药性都非常普遍，临床上应根据药敏检测结果进行用药。

The distribution and resistance characteristics of pathogens in ICU rooms

Objective To study the distribution and drug resistance characteristics of pathogens cultured from the blood samples of ICU patients in a general hospital. Methods 6 400 blood samples were collected from the ICU patients from 2011 Jan to 2013 June for the isolation of pathogens and hence antimicrobial susceptibility test. Results 971 strains of pathogens were isolated from 6 400 blood cultures （15.17%）, in which Gram-positive cocci accounted for 43.77% （425/971）, Gram- negative bacilli 53.04% （515/971）, and fungi 3.19%（31/971 ）. The most common pathogenic bacteria were coagulase-negative staphylococci, Burkholeria cepacia, Escherichia coli, Bauman acinetobacter, Klebsiella pneumonia, Pseudomonas aeruginosa, and Staphylococcus aureus. The methicillin and penicillin resistance rates of Staphylococcus epidermidis and S. aureus were higher than others; the resistance rates of E. coli, P. aeruginosa and K. pneumoniae to imipenem were the lowest. Conclusion Coagulase-negative staphylococci, Burkholeria cepacia and Baurrtan acinetobacter are common pathogens in ICU patients with bloodstream infection, all of which are drug resistant resistant and multi-drug resistant.