ICU常见病原菌分布及耐药性分析

目的 了解重症监护病房(ICU)感染患者病原菌分布和耐药情况,以采取有效防控对策,为临床合理使用抗生素提供理论依据.方法 回顾性分析2006年1月至2008年12月从云浮地区医院ICU患者中分离到的513株病原菌的种类及耐药性.结果 513株病原菌中G-杆菌304株,占59.26%:G+球菌150株,占29.24%,真菌59株,占11.50%.G-杆菌以铜绿假单胞菌、克雷伯菌属、嗜麦芽黄单胞菌、鲍曼不动杆菌为主.G+球菌以金黄色葡萄球菌(MRSA)、表皮葡萄球菌为主.各类细菌对常用抗菌药物表现为严重耐药和多重耐药.在G-杆菌中,铜绿假单胞菌、嗜麦芽窄食单胞菌、不动杆菌对亚胺培南的耐药率达到14.60%以上;4种G+球菌对万古霉素的耐药率为0.00%.结论 加强ICU病房的感染管理,定期监测ICU病房病原菌分布和耐药情况,为临床合理使用抗菌药提供依据,从而达到控制感染、减少新的耐药菌株出现的目的 .

An analysis of the common distribution and drug-resistance of pathogenic bacterium of patients in intensive care unit

Objective To investigate the common distribution and drug-resistance of pathogenic bacterium of patients in intensive care unit (ICU) from comprehensive hospitals of Yunfu area and adopt effective control measures to provide theoretical bases of rational usage of antibiotics for the clinic.Methods The distribution and drug-resistance of 513 strains isolated from patients in ICU collected from 2006 to 2008 were investigated and studied retrospectively.Results Among the 513 strains isolated from patients in ICU,the gram-negative bacillus covered with 59.26%,the gram-positive coccus covered with 29.24%,and the fungus covered with 11.50%.Pseudomonas aeruginosa, Klebsiella, Xanthomonas maltophilia and Baumamfi were the main gram-negative bacillus,Staphylococcus aureus and Staphylococcus epidermidis were the main gram-positive coccus.The resistance rate of Pseudomonas aeruginosa,Stenotropho-monas maltoplfilia and Ancinetobaeter baumamii to Imipenem was over 14.60%,and the resistance rate of four main gram-positive coccus to vancomycin was 0.00%.And the isolaed bacteria showed serious multiple drug- resistance.Conclusions Periodic survey should be done to strengthen the management of infection in ICU,learn the drug resistance and the distribution of bacterium in ICU and instruct to rationally use antibiotics for the clinic,avoid the generation of new drug resistant strains and control the infection of patients in ICU finally.