重症监护病房患者病原菌分布及耐药性分析

目的：调查重症监护病房（ICU）感染患者病原菌的分布及耐药情况，为临床合理选用抗菌药物提供依据。方法：采用VITEK-32全自动细菌鉴定系统及配套的GNI＋、GNS-448和Etest、K-B纸片等方法对病原菌进行鉴定和药物敏感性试验。结果：526株病原菌分别来自呼吸道痰标本270株（51.5%）、血标本79株（15.0%）、尿标本61株（11.6%）、各种分泌物53株（10.1%）、脓液47株（8.9%）及16株其它标本（3.1%）；分离率前5位的细菌分别为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌和金黄色葡萄球菌。革兰阴性杆菌对亚胺培南、哌拉西林/他唑巴坦、丁胺卡那霉素和左氧氟沙星耐药率较低（均〈30.0%），革兰阳性球菌对万古霉素、利奈唑烷、替加环素及呋喃妥因等抗生素几乎完全敏感。结论：ICU感染患者病原菌种类较多，耐药率较高，临床医生应根据实验室药敏结果合理用药，减少耐药菌株的产生。

The distribution of pathogenic bacteria and drug resistance analysis in intensive care unit patients

Objective： To study the distribution and drug-resistance of pathogenic bacteria of patients in intensive care unit （ICU）, and instruct clinical application of antibiotics reasonably.Methods：All specimens isolated and cultured from patients in our hospital were identified and analyzed by using the automatic microorganism analyzer VITEK-32, Etest and K-B.Results：A total of 526 isolates were recovered from clinical specimens of patients in intensive care units （ ICUs） , from 270 respiratory specimens （ 51.5%） , 79 blood specimens （ 15.0%） , 61 urinary specimens （ 11.6%）, 53 secretion specimens （ 10.1%） , 47 pus specimens （ 8.9%） ,and 16 the others（3.1%） . The top 5 most common organisms isolated were Pseudomonas aeruginosa, Escherichia coli , Klebsiella pneumoniae, Acitetobacter baumannii and Staphylococcus aureus. The gram-negagive.Conclusions：The kind of pathogens and rate of drug resistance in ICU are high, and the clinical should use antibiotics reasonably to reduce the rate of drug resistance.