重症、冠心病监护病房菌群分布特点及耐药性分析

目的了解我院2000年1月～2002年5月重症(ICU)、冠心病监护病房(CCU)菌群分布及不同菌的耐药性,以利于临床合理选用抗生素及预防医院感染. 方法选用浙江省军区细菌生化管手工进行细菌鉴定及用K-B法进行药敏试验,用双纸片协同法测定超广谱β-内酰胺酶(ESBLs). 结果共分离出233株菌,这些标本为下呼吸道标本(多数为痰,少数为气管切开分泌物),其中不动杆菌属60株占25.7%,酵母样真菌54株占23.2%,肺炎克雷伯菌42株占18.0%,金黄色葡萄球菌20株占8.6%,铜绿假单胞菌18株占7.7%,产ESBLs肺炎克雷伯菌6株占14.3%,产ESBLs大肠埃希菌3株占18.8%,MRSA检出4株占20.0%. 结论 ICU、CCU为免疫力低下患者,极易感染病原菌或多种菌混合感染,且分离的菌易呈多重耐药,临床治疗较棘手,所以应在抗生素敏感试验指导下进行治疗.

Resistant Bacteria in ICU and CCU:Distribution and Surveillance

OBJECTIVE To investigate the distribution and resistance of bacteria in ICU and CCU. METHODS A total of 233 strains were tested by K-B disc diffusion method. ESBLs were detected by double-disc synergy test. RESULTS Among 233 strains from ICU and CCU from Jan 2000 to May 2002, Acinetobacter, accounted for 60 strains (25.7%), Saccharomyces 54 (23.2%), Klebsiella pneumoniae 42 (18.0%), Staphylococcus aureus 20 ((8.6%) )and Pseudomonas aeruginosa 18 strains (7.7%). Escherichia coli and K. pneumoniae were 18.8% and 14.3%. Four strains of S. aureus were MRSA. The rate of resistance of Acinetobactar to IMP, AMK, CFP, CAZ, CIP, OFL was 0, 5%, 80%, 60%, 56.7%, and 53.3%, respectively; K. pneumoniae resistant to IMP was 0, to AMK and OFL was below 15%, and to SXT and AMP was above 95%; P. aeruginosa resistant to IMP was 0, to AMK and PIP was below 25%. CONCLUSIONS The strains isolated from ICU and CCU are (antibiotic-resistant.) It is very important to select (antibiotics) correctly for infections of the patients in ICU and CCU according to the results of antibiotic susceptibility tests.