重症监护病房感染患者病原菌分布及耐药性分析

目的通过了解ICU感染患者病原菌分布和耐药特点,为临床医生经验性用药及更替使用敏感抗生素提供合理依据。方法对2011年1月-2012年6月ICU病房所分离出的病原菌及耐药特点进行回顾性分析。结果 117株病原菌中革兰氏阴性杆菌占81.2%,其次为真菌占11.1%,革兰氏阳性球菌7.7%;革兰氏阴性杆菌中铜绿假单胞菌占第一位(36.8%),其次为大肠埃希氏菌(19.7%)、不动杆菌属(12.0%);大肠埃希氏菌产超广谱β-内酰胺酶(ESBLs)的检出率为43.5%;分离率较高的革兰阴性杆菌对亚胺培南、美洛培南、哌拉西林/他唑巴坦、环丙沙星高度敏感。结论重症监护病房感染患者病原菌以革兰阴性杆菌为主,耐药情况严重;定期对ICU进行细菌流行病学调查和耐药分析十分重要。

Distribution of pathogens and antimicrobial resistance in ICU

Objective To investigate the distribution of the pathogens and the bacterial resistance from ICU,in order to guide the empirical antimicrobial therapy for ICU doctor.Methods Retrospective analysis was made on the bacteria distribution and antimicrobial resistance situation in our ICU department during the year of Jan 2011 to Jun 2012.Results 81.2% of 117 bactenia strains is Gram negative bacillus.11.1% is fungus and 7.7% is Gram positive coccus.Pseudomonas aeruginosa ranks the top of Gram negative bacillus（36.8%） and the following is E.coli and Acinetobacter which take 19.7% and 12.0% respectively.The detection rates of ESBL-producing bacteria of E.coli were 43.5%.Most of the G-bacilli were sensitive to imipenem,meropenem,piperacillin/tazobactam and ciprofloxacin.Conclusions Most of the patients in ICU are infected wish G-bacilli,and they are the multidrugresistance strains,therefore drug resistance monitoring and distribution investigation of the bacteria in ICU are important to control infection effectively.