危重病监护病房的细菌耐药监测及分析

目的了解危重病监护病房(ICU)医院获得性细菌感染的流行病学及细菌耐药情况的变化. 方法对ICU2001年6月～2004年6月所有细菌分离株及其耐药进行回顾性分析. 结果细菌总数 719株,革兰阴性杆菌56%,革兰阳性球菌36%,真菌8%;革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌的74.2%,耐甲氧西林凝固酶阴性葡萄球菌(MRCN)占凝固酶阴性葡萄球菌84%;革兰阴性菌中,铜绿假单胞菌、脑膜脓毒金黄杆菌、不动杆菌属、肺炎克雷伯菌、洋葱伯克霍尔德菌、嗜麦芽寡养单胞菌、大肠埃希菌和肠杆菌属分别占24.2%、14.8%、10.8%、9.6%、8.6%、8.1%、7.9%和5.4%;亚胺培南、阿米卡星、头孢他啶、环丙沙星对G-菌的敏感率分别为58%、50%、52%、44%;万古霉素对MRSA、MRCN及肠球菌属的敏感率均为100%. 结论革兰阳性菌感染呈上升趋势,细菌耐药率明显升高,监测细菌分布及耐药性变化非常重要.

Nosocomial Bacterial Infection in Comprehensive Intensive Care Unit

OBJECTIVE To establish the pre va lence of nosocomial bacterial infection and resistance in a comprehensive intens ive care unit(ICU). METHODS We retrospectively analyzed all t he bacterial isolates in the ICU of our hospital from 2001 to 2004. RESULTS Among all the bacterial isolates( n=719),the percentage of Gram-negative bacilli,Gram-positives and fungi were 56%,36%,and 8%,respectively.Meticillin resistant Sta phylococcus aureus and meticillin resistant coagulase negative S taphylococcus counted for 74.2% and 84% of Gram-positive pathogens,res pectively.The percentage of Pseudomonas aeruginosa,Chrys eobacterium spp,Acinetobacter spp,Klebsiella pn eumoniae,Burkholderia cepacia,Stenotrophomonas maltophilia,Enterococcus spp and Escherichia coli acco unted for 24.2%,14.8%,10.8%,9.6%,8.6%,8.1%,7.9% and 5.4% of Gram-negat ive bacilli,respectively.The susceptive rate of Gram-negative bacteria to imi penem,amikacin,ceftazidime,ciprofloxacin were 58%,50%,52% and 44%,respectively;the susceptive rate of meticillin-resistant S.aureus,meticill in resistant coagulase negative Staphylococcus and Enter ococcus to vancomycin was all 100%. CONCLUSIONS Gram-positives become impo rtant pathogens of nosocomial infection.Most pathogens show significant resistan ce to the most commonly used antibiotics.It is very important to monitor the dis tribution of bacteria and their resistance to antibiotics.