重症监护病房革兰阴性菌流行分布及耐药性监测

目的分析沈阳军区总医院呼吸内科重症监护室(RICU)革兰阴性菌的流行分布及其对抗菌药耐药的状况。方法对2009年1月—2011年12月RICU收住患者的所有分离菌株进行分析,试验方法严格按照NCCLS最新标准进行。结果 RICU共分离出277株革兰阴性菌,其中铜绿假单胞菌90株(32.49%)、不动杆菌65株(23.47%)、肺炎克雷伯杆菌56株(20.22%),嗜麦芽窄食假单胞菌20株(7.22%),其次为黏质沙雷菌和大肠埃希菌;革兰阴性菌对碳青酶烯类、头孢他啶、头孢哌酮-舒巴坦钠、头孢吡肟、哌拉西林-他唑巴坦和左氧氟沙星仍高度敏感,但不动杆菌的耐药率却不断增高。结论加强革兰阴性菌耐药性的动态监测,对临床医生合理使用抗菌药十分必要。

Surveillance of epidemic distribution and drug resistance of Gram-negative bacteria in our respiratory intensive care unit

Objective To analyze the epidemic distribution and drug resistance of Gram-negative bacteria in respiratory intensive care unit(RICU) of the general hospital of Shenyang military region. Methods All strains of the separation from RICU inpatients during January 2009 to December 2011 were analyzed,and the test method in strict accordance with the latest standards of NCCLS. Results 277 strains isolated RICU gram-negative bacteria,including pseudomonas aeruginosa 90 strains(32.49%),acinetobacter 65 strains(23.47%),pneumonia Klebsiella 56 strains(20.22%),stenotrophomonas maltophilia 20 strains(7.22%),followed by serratia marcescens and escherichia coli;Gram-negative bacteria is still highly sensitive to carbon green enzyme of alkenes, cefotaxime,cefoperazone-sulbactam,cefepime,piperacillin-sulbactam and levofloxacin,but acinetobacter resistant rate constantly increased. Conclusion Strengthen gram-negative bacteria resistant dynamic monitoring is necessary to clinical doctors for the rational using of antimicrobial agents.