革兰阴性菌与NSICU医院感染的关系

目的 研究革兰阴性菌在NSICU环境中的分布及其所致医院感染的特征,为其防治提供理论依据.方法 选取2010年10月-2011年9月某医院NSICU发生医院感染患者进行病原学检查及药敏试验,同时监测NSICU空气和病床单位的细菌学分布特征.结果 209例患者中有61例发生医院感染,感染率为29.2％；其中42例进行了病原学检测,检出革兰阴性菌占77.9％,其中肺炎克雷伯菌和铜绿假单胞菌分别占25.9％和23.3％,均对左氧氟沙星敏感；在病房环境中检出的病原菌以革兰阴性杆菌为主,主要为鲍氏不动杆菌.结论 革兰阴性杆菌是引发NSICU医院感染最重要的病原菌之一,下呼吸道是最易发生医院感染的部位,其病原菌主要为肺炎克雷伯菌和铜绿假单胞菌；NSICU环境是除肺炎克雷伯菌以外的其他革兰阴性杆菌感染的主要传播途径,肺炎克雷伯菌对大多数抗菌药物敏感,而其他革兰阴性杆菌对于多数抗菌药物具有不同程度的耐药性.

Relationship between gram-negative bacteria and nosocomial infections in neurological intensive care unit

OBJECTIVE To analyze the distribution of the gram-negative in neurological intensive care unit environment and the clinical characteristics of nosocomial infection patients in neurological intensive care unit,so as to institute prevention strategy for nosocomial infection caused by G-bacteria.METHODS All inpatients admitted to neurological intensive care unit of the hospital from Dec.2010 to Sep.2011were collected as monitoring objectives.The results of pathogen identification and drug susceptibility test were recorded.The microbiological characteristics of indoor environment(air-environment and the bed-unit) of the ward were also monitored.RESULTS During the study period,there were 61 patients got nosocomial infection among all 209 monitoring objectives,the incidence was 29.2%.42 patients received the pathogenic examination,and G-bacteria accounted for 77.9%.Among the gram-negative bacilli,K.pneumoniae and P.aeruginosa accounted for 25.9% and 23.3% respectively.They were both susceptible to levofloxacin.Bacteria were also detected in ward environment,most of them were gram-negative bacilli,especially ABA.There was no difference of the distributions among indoor air,pillow and quilt(P>0.05).CONCLUSION Gram-negative bacilli are the predominate pathogens in the NICU which would cause nosocomial infections.Lower respiratory tract is the most susceptible location,the major pathogens are K.pneumoniae and P.aeruginosa.The NICU ward environment is one of the most important transmission routes of gram-negative bacilli but not K.pneumoniae.The K.pneumoniae is susceptible to most antibiotic,other gram-negative bacilli have different levels of antimicrobial resistance.