重症监护病房病原菌分布及耐药性变迁

目的了解本院重症监护病房（ICU）最近3年来的病原菌分布情况及其抗菌药物耐药性的变化,为临床合理使用抗菌药物提供科学依据。方法对本院2010年1月～2012年8月所有患者的分离菌株进行回顾性调查与分析。结果 ICU感染细菌以革兰阴性杆菌为主,但阳性球菌有上升趋势,阴性杆菌分离菌种从肺炎克雷伯菌转为鲍曼不动杆菌,阳性球菌以金黄色葡萄球菌为主,两者增加的均是高耐药菌株。肺炎克雷伯菌对亚胺培南、鲍曼不动杆菌对米诺环素、阳性球菌对万古霉素保持高度的敏感性。结论 ICU分离出的细菌以多重耐药菌株增加为主,应加强监测,临床医生应结合本地区细菌流行特点,合理选用抗生素。

The distribution and antibiotic resistant of pathogenic bacteria in intensive care unit

Objective To investigate distribution and antibiotic resistant of pathogenic bacteria in intensive care unit （ICU）,and to direct clinical doctor using antimicrobial agents with reason.Methods The data of all the isolated strains from patients from Jan 2010 to Aug 2012 were retrospective investigated and analysed.Results Gram negative bacillus was priority to ICU bacterial infection,but positive cocci were on the rise.Negative bacillus strains from Klebsiella pneumoniae to Bauman Acinetobacter,positive cocci was main Staphylococcus aureus,the high resistant strains were increased in both.Klebsiella pneumoniae to imipenem,Bauman Acinetobacter to minocycline,positive cocci to Vancomycin,all had a high degree of sensitivity.Conclusion The isolated bacteria strains from ICU mainly to increase with multiple drug-resistant strains,clinicians should strengthen the monitoring and combine with local bacterial epidemic characteristics,reasonable use of antibiotics.