重症监护病房医院感染病原菌监测

目的了解我院重症监护病房(ICU)医院感染病原菌分布及耐药特点,探讨临床防治对策。方法收集2002年1月~2005年12月入住我院ICU的891例医院感染患者的临床资料,分析标本来源、病原菌分布及耐药情况。结果分离所得1 155株菌株中革兰阴性菌(G-菌)居多,占57.84%,其次分别为革兰阳性菌(G 菌)(21.39%)和真菌(20.78%)。多数G-菌对亚胺培南耐药率较低(0~10.16%),而铜绿假单胞菌对阿米卡星和头孢哌酮/舒巴坦耐药率最低,分别为6.89%和33.97%。G 菌对万古霉素敏感性最高。真菌中以白假丝酵母菌(42.92%)和酵母样菌(22.90%)多见。结论加强ICU病原菌流行病学调查对合理使用抗菌药物,减少耐药菌株的产生和流行有重要临床指导价值。

Surveillance of pathogens from patients with hospital infection in intensive care unit

Objective To analyze the distribution and antimicrobial resistance of pathogens from patients with hospital infection in intensive care unit(ICU),and to discuss the corresponding strategy of prevention and treatment. Methods Clinical data of 891 patients hospitalized in the ICU of our hospital between Jan 2002 and Dec 2005 were collected.All the specimens were analyzed for pathogen distribution and resistance to antibiotics. Results Of all the isolated 1 155 strains,Gram-negative(G-)bacteria were the most popular pathogen(57.84%),whereas Gram-positive(G ) bacteria and fungi accounted for 21.39% and 20.78%,respectively.Most G-bacteria were less sensitive to imipenem(0-10.16%),and Pseudomonas aeruginosa was least sesitive to amikacin(6.89%) and cefoperazone-sulbactam(33.97%).G bacteria were most sensitive to vancomycin.Most fungus were Candida albicans(42.92%) and yeast species(22.90%). Conclusion Epidemiological investigation of pathogens in ICU is of great importance to the rational use of anti-biotics and may help to reduce the emergence of resistant strains.