重症监护病房医院感染病原菌分布与耐药性分析

目的探讨外科重症监护病房（SICU）患者感染病原菌的分布及耐药性特征,为本院SICU防治院内感染提供参考。方法对我院2006年1月～2007年12月SICU各类感染标本所分离的菌株分布及细菌耐药性进行回顾性分析。结果分离出的348株细菌中以革兰阴性杆菌为主,占71.8%,其次为真菌14.4%,革兰阳性球菌占10.9%。革兰阴性杆菌中铜绿假单胞菌占第一位（29.4%）,其次为大肠艾希菌和克雷伯菌属,各占18.1%和13.8%。铜绿假单胞菌呈多重耐药性,对亚胺培南的耐药率达16.7%,耐甲氧西林的金黄色葡萄球菌的检出率为90.9%,产超广谱β-内酰胺酶大肠艾希菌和克雷伯菌属的检出率分别为69.8%和79.2%,真菌以白色假丝酵母菌为主,占60.2%。结论外科ICU的院内感染及多重耐药情况严重,加强病原菌分布及耐药性的监测,对指导临床合理用药十分重要。

Distribution and drug resistance of bacteria isolated from patients with hospital infection in ICU of surgical department

Objective To understand the distribution of pathogenic bacteria and drug resistance of ICU patients in the surgical infections and provide evidence for treantment of nosocomial infection. Methods The distribution and drug resistance of bacteria isolated from ICU patients during January 2006 and December 2007 were analyzed. Results Totally 348 stains of bacteria were isolated and gram negative bacteria accounted for 71.8%, followed by fungus and gram positive bacteria occupied 14.4% and 10.9%, respectively. Pseudomomas aeruginosa ranks the first of gram negative bacteria （29.4%） and followed by Escherichia coli and Klebsiella pneumoniae accounted for 18. 1% and 13. 8% respectively. Pseudomomas aeruginosa was multidrug - resistant with a drug resistance rate to zmipenem of 16.7%. The detection rate of MRSA was 90. 9% and the detection rates ofEscherichia coli and Kelbsiella pneumoniae all producing ESBL were 69.0% and 78.8%. With regard to fungus, Candida albicans predominated （60.2%）. Conclusion The bacterial infection in ICU and the multijrle drug resistance is serious. Therefore monitoring of drug resistance of bacteria to antibiotics be carried out to guide rational use of antibiotics in clinical treatment.