NSICU病原菌感染特点及耐药性分析

目的 了解神经外科重症监护病房(NSICU)医院感染,常见病原菌的分布及其耐药性,为临床合理用药和控制医院感染提供依据.方法 以回顾性分析的方法,对2009年1月-2010年12月自NSICU患者送检的各类标本中分离出的病原菌,采用英国先德ARIS 2X微生物分析系统对病原菌进行耐药性分析.结果 共检出733株病原菌,革兰阴性杆菌占73.3％,革兰阳性球菌占23.7％,真菌占3.0％；革兰阴性杆菌以铜绿假单胞菌为主,占20.5％,革兰阳性球菌以凝固酶阴性葡萄球菌为主,占18.3％;病原菌以痰标本检出率最高,占76.9％,其次是头部切口引流液占17.5％；病原菌耐药率高,多药耐药性严重.结论 NSICU患者感染率高,以呼吸道感染为主,其次是头部切口感染；病原菌以革兰阴性菌为主,多药耐药株较多,全面系统地监测NSICU感染特点及细菌耐药动态,有利于控制医院感染及耐药菌流行.

Characteristics and drug resistance of nosocomial infections caused by pathogens in neurosurgical intensive care unit

OBJECTIVE To study nosocomial infections in a neurosurgical intensive care unit(NSICU),including the distribution of the common pathogens,and the current status of drug resistance,so as to provide evidence for reasonable use of antibiotics and control of nosocomial infections.METHODS A retrospective analysis of the pathogens isolated from various specimens in NSICU from Jan.2009 to Dec.2010 was performed,UK ARIS 2X microbial analysis system was adopted to analyze the drug resistance of the pathogens.RESULTS Totally 733 strains of pathogens were isolated,among which gram-negative bacilli accounted for 73.3%,gram-positive cocci accounted for 23.7%,and fungi accounted for 3.0%.Pseudomonas aeruginosa isolates were the predominant gram-negative bacilli,accounting for 20.5%,coagulase-negative Staphylococcus isolates were the predominant gram-positive cocci,accounting for 18.3%.The detection rate of the pathogens isolated from sputum specimens was the highest(76.9%),followed by the drainage fluid from head incision(17.5%).The rate of drug resistance of the pathogens was high,and multidrug resistance was serious.CONCLUSION The rate of infections in patients of NSICU is high,respiratory tract infection is predominant,followed by head incision infection.Gram-negative bacteria are the predominant pathogens,with many multidrug-resistant strains.The characteristics of infections in NSICU and dynamics of bacterial resistance are monitored in a comprehensive and systematic manner,which may help to control the nosocomial infections and the prevalence of resistant strains.