ICU血流感染的病原菌分布及耐药性分析

目的 了解ICU血培养分离病原菌的分布及耐药性.方法 回顾性调查2006年1月-2010年1月医院ICU临床血培养病原菌分布特点和耐药性.结果 结果血培养阳性率为18.3％,共获得临床分离病原菌217株,47.9％为革兰阴性杆菌,其中肠杆菌科细菌70株,占32.3％,革兰阳性菌占37.4％,真菌占14.7％;最常见的分离病原菌依次为大肠埃希菌、金黄色葡萄球菌和肺炎克雷伯菌,分别占15.6％、13.8％、9.7％;大肠埃希菌和肺炎克雷伯菌产ESBLs检出率分别为47.1％和42.8％,肠杆菌科细菌未发现碳青霉烯类耐药菌株,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为73.3％和78.8％;未发现耐万古霉素葡萄球菌属和肠球菌属.结论 ICU血流感染以革兰阴性菌为主,真菌性感染呈上升趋势;血培养分离株耐药现象普遍.

Distribution and antibiotic resistance of pathogens causing bloodstream infections in ICU

OBJECTIVE To investigate the distribution and antimicrobial resistance of blood culture pathogens in ICU.METHODS The clinical distribution and drug resistance of pathogens cultured from blood in ICU from Jan.2006 to Jan.2010 were analyzed retrospectively.RESULTS The positive rate of blood culture was 18.3%.Totally 217 strains of clinical isolates were acquired,47.9% were gram-negative bacilli among which 70(32.3%) strains were Enterobacteriaceae.Gram-positive cocci accounted for 37.4% and fungi accounted for 14.7%.Escherichia coli(15.6%),Staphylococcus aureus(13.8%),and Klebsiella spp(9.7%) were most frequently isolated.The detection rates of ESBLs-producing E.coli and Klebsiella spp were 47.1% and 42.8%,respectively.No strains of Enterobacteriaceae resistant to carbapenem were detected.The detection rates of methicillin-resistant S.aureus(MRSA) and methicillin-resistant coagulase-negative Staphylococcus(MRCNS) were 73.3% and 78.8%,respectively.No vancomycin-resistant Staphylococcus or Enterococcus isolates were found.CONCLUSION Gram-negative bacilli are the dominant pathogens causing bloodstream infections in ICU,and fungal infections keep an upward tendency.The drug resistance of the isolates from blood culture is commonly presented.