ICU病人感染的细菌分离及耐药性分析

①目的 了解ICU病人感染细菌分布特点及耐药情况，探讨临床防治对策。②方法 回顾性总结2002年9月～2003年6月我院ICU收治感染病人97例的临床资料、感染病原菌谱、耐药性及临床特点，并对相关因素进行分析。③结果 97例感染病人共分离出细菌374株，以G^-杆菌为主（占72．63％），球菌及真菌比例较高（分别占17．20％和10．17％）。G^-杆菌中铜绿假单胞菌占第一位（20．86％），除大肠艾希菌（36％）外，肺炎克雷伯菌、黏质沙雷菌、鲍曼不动杆菌、阴沟肠杆菌产生超广谱β-内酰胺酶（ESBL）比率均在70％以上；G^＋球菌主要为金黄色葡萄球菌，其中耐甲氧西林金黄色葡萄球菌（MRSA）占96．77％；真菌以白假丝酵母菌为主，对氟康唑、铜康唑及两性霉素B均敏感。病人感染除自身情况（高龄）及基础疾病因素外，与抗生素及制酸剂的使用、介入性操作等有关。④结论 ICU病人感染及多重耐药情况严重，为控制感染及耐药菌播散，必须严格合理使用抗生素，尽量减少制酸剂的使用及不必要的介入性操作。

AN ANALYSIS OF BACTERIAL INFECTION AND ISOLATION AND DRUG RESISTANCE OF PATIENTS IN ICU

Objective To understand the pattern of bacteria infected and drug resistance in ICU patients and study its countermeasures. Methods The clinical data of ICU patients and the bacterial spectrum and drug resistance from Sept., 2002 to June, 2003 were analyzed retrospectively. Results In 374 strains isolated from 97 cases infected, G - bacilli, cocci and fungi accounted for 72.63%, 17.20%, and 10.17%, respectively. Most of the G - bacilli were pseudomonas aeruginosa strains ( 20.86% ). Except E.coli (36%), the rate of the ESBL-producing bacteria of Kopneumoniae, Serratia Marcessens, Acinetobacter, Enterobacter, and Cloacae, were higher than 70%. In G + cocci, Staphylococcus aureusa(SA) was the most prominent and MRSA was 96.77% in SA. The ratio of fungi was 10.17%. Cadida albicans was the most. And all the fungi were sensitive to Amphotericin B., Fluconazol E, and Ketoconazole. Infections were correlated with the usage of antibiotics and antiacids and the invasive operations besides the underlying disease of patients. Conclusion The infection and multi-drug resistance of infectious bacteria are serious in ICU. It is important to use antibiotics rationally and to decrease the usage of antiacids and unnecessary invasive operation as much as possible.