连续四年ICU病房院内感染病原菌的耐药性分析

目的 :了解我院重症监护病房 (ICU)院内感染病原菌的耐药性变化趋势。方法 :对我院 ICU2 0 0 0年 1月至 2 0 0 3年 12月院内感染的各类感染标本中分离的 74 1株病原菌加以整理分析 ,并按美国国家临床实验室标准委员会 (NCCL s)标准进行药敏试验 ,并对其耐药性进行分析。结果 :分离出的菌株以革兰阴性杆菌为主 ,其次是革兰阳性球菌、真菌 ,分别占 6 2 % ,2 9% ,9% ,感染部位以肺部最多 5 5 1株 (74 .4 % ) ,泌尿道感染 5 0株 (6 .7% ) ,引起败血症35株 (4.7% ) ,来自各种体液 (胸、腹水、胆汁 ) 5 2株 (7.0 % ) ,来自各种引流液和伤口分泌物 2 5株 (3.4 % ) ,静脉导管13株 (1.8% ) ,其他 15株 (2 .0 % )。革兰阴性杆菌以非发酵菌为主 ,其中铜绿假单胞菌 135株 (18.2 % )、嗜麦芽窄食单胞菌 38株 (5 .1% )、不动杆菌属 37株 (4.9% )及其他非发酵菌 5 7株 (7.7% ) ,其次大肠埃希菌 91株 (12 .3% )、肺炎克雷伯菌 5 3株 (7.2 % )、肠杆菌属 33株 (4.5 % )、其他肠杆菌科 17株 (2 .3% )。铜绿假单胞菌对亚胺培南的耐药率达 4 1.0 % ,呈多重耐药 ,阴沟肠杆菌对头孢他啶、氨曲南的耐药率达 6 0 .0 %、73.3% ,大肠埃希菌、肺炎克雷伯菌产超广谱β-内酰胺酶 (ESBL s)的发生率分别是 4 1.0 %、4 5 .0 % ,亚胺培南?

Continuous Surveillance of Nosocomail Pathogen Distrebution and Antimicrobial Resistance in Intensive Care Unit

Objective This study is an attempt to know the nosocomail pathogens and resistance rates isolated from intensive care unit(ICU).Methods 741 strains of pathogens were isolated from Januaryl,2000 to December 31,2003 in intensive care unit of our hospital.Antibiotic sonsitivity test was done according to Kirby Bauer method of NCCLS 1999.Results Nosocomail infection in intensive care unit was highest among gram-negative bacteria,espectically with Pseudomonas aeruginosa(18.2 %),Pseudomonas aeruginosa were the most prevalent isolates from ICU infections followed by Escherichiacoil(12 %),Klebsiella pneumoniae(7.2 %),Xanthomonas sp(5.1 %),Acinetobacterspp(4.9 %).Pseudomonas aeruginosa were 41 % resistant to imipenem.It was CROSS-resistance.41 %strain of E.coli and 45 % Klebsiellapneumoniae Were produing extended-spectrum beta-lactamases(ESBLs).Only imipenem remained highly active against Enterbacteriaceae With a phenotype suggesting possible production of an extended-spectrum beta-lactamase and those With a phenotype suggesting possible AmpC hyperproduction.Vancomycin resistant staphy lococci were not found.Conclusions The most common pathogens causing nosocomailinfection were gram-negative bacteria.The rostance rates were high.Antibiotics policy is urgently needed in order to delay the resistance development.