辽西地区重症监护室患者病原菌分布及耐药性分析

目的分析3所综合性三级甲等医院近3年重症监护室(ICU)患者的菌群分布和耐药性,为临床治疗提供依据。方法选择2015—2017年3所医院ICU1856株病原菌,用MicroScan WalkAway 96及VITEK2进行菌株鉴定及药敏分析。结果革兰阴性菌占68.32%(1268/1856),革兰阳性菌占15.41%(286/1856),真菌占16.27%(302/1856);革兰阴性菌以鲍曼不动菌为主,革兰阳性菌以表皮葡萄球菌为主,真菌感染有上升趋势;鲍曼不动杆菌对氨苄西林、头孢噻肟、头孢曲松、头孢唑林、头孢西丁、氨曲南的耐药率均>95.0%,革兰阳性菌对万古霉素最为敏感,但对青霉素G、红霉素的耐药率均>70.0%。结论ICU患者感染病原菌仍以革兰阴性菌为主,且耐药严重。

Distribution and drug resistance of pathogenic bacteria in patients with ICU in western Liaoning province

Objective To investigate the distribution of bacteria and drug resistance in ICU patients in three general Grade 3A hospitals during the recent three years, so as to provide the basis for clinical treatment. Methods Retrospective analysis of 1856 cases of pathogenic bacteria were selected from ICU of three hospitals during 2015—2017. The strain identification and drug sensitivity analysis were analyzed with the MicroScan WalkAway 96 and VITEK 2 bacterial susceptibility analyzer. Results Gram-negative bacteria accounted for 68.32% (1,268/1,856), Gram-positive bacteria accounted for 15.41% (286/1856), and fungi accounted for 16.27% (302/1,856). Acinetobacter baumannii was the main strain of Gram-negative bacteria isolated, Staphylococcus epidermidis was the dominant bacteria in Gram-positive bacteria, and fungal infections were on the rise. The resistance rates of A. baumannii to ampicillin, cefotaxime, ceftriaxone, cefazolin, cefxitin and aztreonam were more than 95.0%. The strain Gram-positive bacteria were most sensitive to vancomycin, but the resistant rates to penicillin G and erythromycin were more than 70.0%. Conclusion The pathogens of ICU were still Gram-negative bacteria, and the drug resistance was serious.