ICU患者痰主要病原菌分布及耐药性分析

目的探讨重症监护病区(ICU)患者呼吸道感染的病原菌分布及耐药性,以指导临床合理应用抗菌药物。方法回顾性分析ICU病区2010年1月～2011年11月痰培养分离出的主要病原菌及耐药性情况。结果 987例痰标本共分离病原菌362株,阳性率36.7%。其中革兰阴性杆菌(G-)占73.21%,主要有铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽窄食单胞菌;革兰阳性球菌(G+)占19.34%,主要为金黄色葡萄球菌;真菌占7.45%。药敏结果表明,所有革兰阴性菌对抗菌药物的耐药率呈上升趋势。结论革兰阴性杆菌仍是ICU病区肺部感染的主要病原菌,其中鲍曼不动杆菌、铜绿假单胞菌占据前2位,真菌感染占有一定比例,多重耐药现象较严重。因此加强耐药性监测、合理应用抗菌药物、预防交叉感染十分重要。

Analysis of the phlegm main pathogenic bacteria distribution and drug resis- tance of ICU patients

Objective To explore intensive care ward （ICU） patients with respiratory infection of the pathogen distribution and drug resistance, in order to guide clinical rational application of antimicrobial agents. Methods Ward ICU were ana- lyzed retrospectively from January 2010 to November 2011 period sputum cultures of the main pathogenic bacteria isolated and resistance. Results A total of 987 cases of sputum samples were separated 362 strains of pathogenic bacteria, positive rate was 36.7%. Gram-negative bacilli （G-） accounted for 73.21%, basically had pseudomonas aeruginosa, acinetobacter baumanii, klebsiella pneumoniae, escherichia coli, stenotrophomonas mahophilia; gram-positive coccus （G＋） accounted for 19.34%, basically have staphylococcus aureus; the fungi was 7.45%. According to antimicrobial susceptibility test results indicated that all gram-negative bacterium antimicrobial resistant to the rise. Conclusion Gram-negative bacilli is still ward ICU pulmonary infection main pathogens, including acinetobacter baumanii, pseudomonas aeruginosa the top two, fun- gal infection proportion, multiple drug-resistant phenomenon more serious. Therefore strengthen resistance monitoring, and the reasonable application of antimicrobial drugs, preventing cross infection are very important.