2009～2011年ICU患者细菌分布及其敏感性调查

目的监测笔者所在医院ICU患者病原菌流行病学分布及敏感性状况。方法收集ICU科室2009年1月~2011年12月送检病原学标本中分离的病原菌及药敏鉴定结果,统计病原菌分布和抗菌药物敏感率。结果分离到病原菌822株,其中革兰阳性球菌197株,占24%;革兰阴性杆菌625株,占76%。排名前6位的病原菌分别为:鲍曼不动杆菌(23.1%),金黄色葡萄球菌(16.9%),肺炎克雷伯菌(14%),铜绿假单胞菌(12.5%),嗜麦芽窄食单胞菌(8.9%),大肠埃希菌属(7.8%)。耐甲氧西林金黄色葡萄球菌检出率为28.9%,尚未发现耐万古霉素的菌株。肠杆菌科细菌对碳青霉烯类高度敏感。鲍曼不动杆菌耐药严重,对亚胺培南的敏感性从91.7%下降到14.8%,对美罗培南则由100%降至13.6%,铜绿假单胞菌的敏感性则保持相对稳定。肠杆菌属对碳青霉烯类保持高度敏感,而大肠埃希菌对三代头孢敏感性下降明显。肺炎克雷伯菌敏感性相对稳定。结论笔者所在医院ICU患者细菌以革兰阴性杆菌多见,革兰阳性球菌则以金黄色葡萄球菌为主,鲍曼不动杆菌呈逐渐增加的耐药趋势,其它药物则保持相对稳定的敏感性。

Antimicrobial susceptibility and distribution of bacteria isolated from ICU patients from 2009 to 2011

Objective To investigate the distribution and antibiotic susceptibility of bacteria isolated from ICU patients from 2009 to 2011.Methods The data of bacteria isolated from ICU of Jiaozuo people’s Hospital were collected from Jan.2009 to Dec.2011.Distribution and antibiotic susceptibility of bacteria were analyzed retrospectively.Results Of 882 isolates,Gram positive cocci and Gram negative bacilli accounted for 24%(197 isolates) and 76%(625 isolates),respectively.The most frequently isolated bacteria was Acinetobacter spp.(23.1%) followed by Staphylococcus aureus(16.9%),Klebsiella pneumoniae(14%),pseudomonas aeruginosa(12.5%),Stenotrophomonas maltophilia(8.9%),and Enterobacter spp.(7.8%).Among those bacteria Acinetobacter spp.increased rapidly.No Staphylococcus aureus was found to be resistant to Vancomycin,and Methicillin-resistant Staphylococcus aureus(MRSA) was accounted for 28.9%.Enterobacter spp.was highly susceptive to Carbapenems.For Acinetobacter spp.high resistant was found,the susceptility to imipenem dropped from 91.7% to 14.8% and to meropenem from 100% to 13.6%.For Pseudomonas aeruginosa and Klebsiella pneumoniae it still had the stable susceptility.While the susceptility of Enterobacter spp.to third-generation cephalosporins dropped significantly.Conclusion Gram negative bacilli were much more common in ICU patients,and Staphylococcus aureus was the most frequent Gram positive cocci.