ICU病区医院感染病原菌流行菌株及耐药性分析

目的调查分析重症监护病房（ICU）医院感染的病原菌流行菌株分布、耐药情况及其耐药性变化趋势,为临床医生正确使用抗生素提供依据。方法对ICU2004年1月～2009年1月所分离出的病原菌株及其耐药性进行回顾性调查分析。结果共检出病原菌1008株,其中革兰阴性菌766株（75.9%）,以铜绿假单胞菌、大肠埃希菌、鲍氏不动杆菌、肺炎克雷伯菌为主,主要见于呼吸道感染;革兰阳性球菌242株（24.1%）,以葡萄球菌属和肠球菌属为主,主要见于呼吸道和泌尿道感染;病原菌对常用抗菌药物耐药严重,且呈多药耐药,革兰阳性菌分离率逐年增多,革兰阴性菌对主要抗菌药物的耐药率呈逐年上升之势。结论ICU医院感染的部位主要是呼吸道,以革兰阴性菌为主,对常用抗菌药物耐药严重,且呈多重耐药,需严格掌握抗菌药物使用原则,根据药敏选用抗菌药物。

Prevailing bacteria strains of hospital acquired infections in intensive care unit and their drug-resistances

[Objective] To investigate the prevailing bacteria pathogens of hospital acquired infections in ICU and their drug-resistances and to provide treatment basis for clinicians to select antibiotics correctly. [Methods] A retrospective investigation analysis was made for all the isolated bacteria as well as their drug-resistance in our hospital from Jan 2004 to Jan 2009. [Results] Totally 1008 bacterial strains Were isolated including 766 strains of Gbacteria （75.9%） and 242 strains of G^＋ bacteria （24.0%）. The G^- bacteria included Pseudomonas aeruginosa, Escherichia eoli, Acinetobacter baumannii, Klebsiella pneumoniase etc, which were isolated mainly from respiratory tract. The G^＋ bacteria consisted of Staphylococcus and Enterococcus. Saphylococcus were mainly isolated from respiratory tract and Enterecoceus from urinary tract. Bacteria were highly resistant to commonly used antimicrobials and demonstrated multi-drug resistance. The isolated rate of G^＋ bacteria and drug resistance of G^- bacteria to the commonly used antibiotics was increasing yearly. [Conclusion] The pathogens are mainly isolated from respiratory tract and the most are G^- strains and multi-drug resistant. The selection and use of antibiotics should be based on the results of drug-sensitivity tests.