综合重症监护病房院内感染病原菌的变迁及耐药性分析

目的探讨综合重症监护病房院内感染病原菌的变迁及耐药情况,为临床合理治疗提供参考。方法查阅2013年1月-2017年12月ICU患者的病历资料,逐一进行统计分析。结果2013年ICU院内感染的病原菌以革兰阳性球菌为多见,2014年和2015年以革兰阴性杆菌为主,其次为革兰阳性球菌和真菌,2016年和2017年仍以革兰阴性杆菌为主,但真菌感染率超过革兰阳性菌。感染部位以呼吸道感染为最多见,占64.11%;药敏结果显示:主要革兰阴性杆菌对亚胺培南和头孢哌酮/舒巴坦耐药率较低,均在20%以下;革兰阳性球菌对万古霉素、替考拉宁100%敏感。结论温岭东方医院综合ICU目前院内感染以革兰阴性杆菌为主,所检出的病原菌对常用抗菌药物表现出较为严重的耐药和多重耐药。医院应加强和分析ICU院内感染病原菌种类及耐药性变迁的动态监测,便于采取有效措施防止和控制院内感染。

Changes and drug resistance of pathogenic bacteria in nosocomial infection in ICU

Objective To investigate the change and drug resistance of nosocomial infection pathogens in ICU and to provide reference for clinical rational treatment.Methods The medical records of ICU from January 2013 to December 2017 were analyzed retrospectively.Results Gram positive cocci was the most common pathogen of nosocomial infections in ICU in 2013.Gram-negative bacteria were the main pathogens,followed by Gram-positive cocci and fungi in 2014 and 2015.Gram-negative bacilli were the main pathogens in 2016 and 2017,but the infection rate of fungi was higher than that of Gram-positive bacteria.Respiratory tract infection was the most common infection site,accounting for 64.11%.Drug susceptibility test showed that major Gram-negative bacilli had lower resistance rates to imipenem and cefoperazone/sulbactam than 20%.Gram-positive cocci were 100%sensitive to vancomycin and teicoplanin.Conclusion Gram-negative bacilli are the main reason for nosocomial infections in ICU.The pathogens detected in ICU show severe drug resistance and multiple drug resistance to commonly used antibiotics.Hospitals should strengthen and analyze the dynamic monitoring of pathogenic bacteria and drug resistance changes in ICU nosocomial infections so as to take effective measures to prevent and control nosocomial infections.