重症监护病房下呼吸道感染常见病原菌的分布与耐药性

目的调查我院重症监护病房(ICU)下呼吸道感染病原菌的分布与耐药情况。方法对本院ICU病房116例下呼吸道感染病人所分离的感染菌株及对抗生素耐药性进行回顾性分析。结果主要菌群有铜绿假单孢菌(25.0%)、肺炎克雷伯菌(18.4%)、鲍曼不动杆菌(14.3%)和大肠埃希菌(9.2%)等。但葡萄球菌、肠球菌等阳性球菌(9.2%)及真菌(13.3%)也有增加趋势。头孢哌酮-舒巴坦和亚胺培南仍保持最高抗菌活性,细菌的耐药率分别为16.9%和24.4%。铜绿假单孢菌,对阿米卡星、头孢哌酮-舒巴坦、亚胺培南的敏感率较高。结论我院ICU病房下呼吸道感染主要病原菌是革兰氏阴性菌,对常用抗菌药物耐药性较高,但革兰氏阳性球菌及真菌所占比例呈增高趋势,加强耐药性监测,合理使用抗生素十分重要。

The distribution of common pathogens and their antibiotic resistance in lower respiratory tract infections in intensive care units

Objective To investigate the distribution of common pathogens and their antibiotic resistance from patients with lower respiratory tract infections in ICU.Methods Bacterial distribution and drug resistance from ICU patients with lower respiratory tract infections were studied retrospectively. Results Pathogens included p.aeruginosa (25%), klebsiella pneumoniae (18.4%), acinetobacter spp (14.3%) and escherichia coli (9.2%). But gram-positive cocci (9.2%) such as staphylococci and enterococci as well as fungi (13.3%) were also seen increasing. The resistance rates to cefoperazone/sulbactam and imipenen were the lowest, being 16.9% and 24.7%, respectively. Most strains of p.aeruginosa were resistant to all antibiotics tested, but they were still sensitive to amikacin, cefoperazone/sulbactam, and imipenen.Conclusion Resistance rates of bacterial in lower reapiratory tract infections in ICU are high. Gram-negative bacilli are the most common pathogens. It is urgent to establish a surveillance system on bacterial resistance and select antibiotics for the treatment of infections in ICU according to the results of susceptibility tests.