重症监护病房患者下呼吸道院内感染细菌及其耐药性分析

目的探讨重症监护病房患者院内感染细菌分布特点及耐药情况。方法回顾性总结2004年5月至2006年6月本院重症监护病房103例院内感染(nosocomial infection,NP)患者的临床资料、感染病原菌谱及耐药性,并对相关因素进行分析。结果103例感染患者共分离出细菌117株,以G-杆菌为主(占68.4%),球菌比例较低(占21.4%)。G-杆菌中铜绿假单胞菌占第一位(31.6%),其次为大肠埃希氏菌(18.8%)、肺炎克雷伯菌(17.1%)。球菌主要为金黄色葡萄球菌,其中耐甲氧西林金黄色葡萄球菌(methicillin resistant staphylococcus aureus,MRSA)占46.2%。G 菌占35.2%,真菌占18.3%。结论ICU患者下呼吸道感染的病原菌以G-杆菌为主,病原菌显示多重耐药,G-杆菌对亚胺培南敏感性较好,而G 菌对万古霉素敏感应根据药敏选择抗菌素。

Clinical investigation of nosocomial pathogens in patients with lower respiratory tract infection in intensive care unit

Objective To investigate the distribution of pathogens and their antibiotic resistance in patients with lower respiratory tract infection in intensive care unit.Method The clinical data,bacterial spectrum and drug resistance of intensive care unit patients from May 2004 to June 2006 were analyzed retrospectively.Results A total of 117 pathogens were identified from the sputum in 103 patients.The rate of gram-negative bacteria and gram-positivebacteria were 68.4% and 21.4%,respectively.The most common pathogens of gram-negative bacteria in low respiratory tract were pseudomonas aeruginosa (31.6%),E.coli(18.8%),Kopneumoniae(17.1%),and among gram-positive bacteria strains the Stphylococus auruginosa was the prominent and MRSA was 46.2%.Conclusions The gram-negative bacteria,which presented with multi-resistant,were the most pathogens,and they were sensitive to imipenem;gram-positive bacteria were sensitive to vancomycin.The drug sensitivity test required were significant in proper selection of antibiotics.