重症监护病房革兰阴性杆菌的分布及耐药分析

目的分析重症监护室（ICU）革兰阴性杆菌的分布及耐药特征,为临床防治提供依据。方法对四川省部分三级甲等医院ICU病房2003年9月~2005年11月各类感染标本所分离的772株革兰阴性杆菌的菌群分布及耐药性进行回顾性分析。结果占前6位的革兰阴性杆菌为铜绿假单胞菌、不动杆菌属、阴沟肠村菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽窄食单胞菌。铜绿假单胞菌及不动杆菌属呈多重耐药,亚胺培南对产酶的阴沟肠杆菌及肺炎克雷伯菌,大肠埃希菌仍保持有较高的抗菌活性。结论ICU中感染的革兰阴性杆菌均有严重的耐药性,这使某些感染的治疗变得非常困难,甚至危及生命,及时掌握病原菌及监测耐药性的最新动态,指导临床医生合理选用抗生素,意义十分重大。

Analysis of distribution and antimicrobial resistence among gram-negative bacilli isolated from intensive care units

Objective To investigate the distribution and antimicrobial resistance among gram-negative bacilli isolated from intensive care units (ICUs), and to provide guidance for clinical therapy.Methods The distribution and antimicrobial resistance of 772 strains of gram-negative bacilli were analyzed. The strains were isolated from intensive care units (ICUs) from Sep.2003 .to Nov.2005.Results The most predominant gram-negative bacillus in order was Pseudomonas aeruginosa, Minetobacter sppp, Entemohacter cloacae, Klebsiellla pneumoniae, Escherichia coli and Stenotrphomonas (Xantho) mltophi respectively. Pseudomonas aemginosa and Acinetobaeter spp had multidrug resistance, while Enterobacter cloacae, Klebsiella pneumoniae and Escherichia coli were still sensitive to Imipenem.Conclusion Most gram-negative bacilli in ICUs have serious drug-resistance, which makes the cure of some infectious diseases very difficult, even threating to life. So detecting pathogens in time and monitoring the new information of drug-resistance might guide doctors to use antibiotics rationally.