普通科室分离菌与ICU分离菌分布及耐药性的对比性研究

目的：了解2013年安徽医科大学附属省立医院普通科室分离菌和ICU分离菌之间细菌分布和对抗菌药物耐药性的分析研究。方法收集临床各科室送检的病原体,分离培养与鉴定,并对ICU与普通科室分离的病原体的分布及耐药性进行对比分析。对ICU临床分离菌的分布和耐药情况和普通科室分离菌进行比较性研究。结果2013年全院共分离4052株,其中普通科室3068株,ICU 984株,均以杆菌为主,其中普通科室杆菌依次为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯杆菌和鲍曼不动杆菌,共占48．5%,球菌主要为金黄色葡萄球菌及肠球菌,共占13．3%。 ICU杆菌依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌、大肠埃希菌,共占64．0%,球菌为肠球菌及金黄色葡萄球菌,共占11．2%。普通科室分离大肠埃希菌、肺炎克雷伯杆菌、铜绿假单胞菌对碳青霉烯敏感性较高,分别在90．0%、80．0%、60．0%以上,而鲍曼不动杆菌只有29．7%敏感；金黄色葡萄球菌对苯唑西林敏感率54．7%。而ICU分离的除大肠埃希菌对亚胺培南敏感性为98．5%,铜绿假单胞菌及肺炎克雷伯敏感率仅达到50．0%,鲍曼不动杆菌耐药严重,敏感率只有6．0%。球菌属对苯唑西林敏感率只有33．3%,统计后较普通科室无明显差异。结论 ICU分离菌和普通科室分离菌分布及耐药性存在明显差异,其中革兰阴性杆菌分布及耐药性较普通科室比例明显增加。故定期进行全院及ICU细菌耐药性监测,将有助了解ICU细菌的分布和耐药情况,从而指导临床合理用药。

General department isolated bacteria separated from ICU bacteria distribution and drug resistance of comparative research

Objective To investigate the research of bacteria distribution between bacteria isolated from general de-partment and ICU and of the antibacterial drug resistance from our hospital in 2013 . Methods The pathogen was collected to cultivate and identify from clinic department,and to analyse the distribution of pathogens and drug re-sistance between ICU and general department in our hospital in 2013 . The isolated bacteria distribution and drug resistance in general wards were compared with the ICU. Results Partial separation of 4 052 strains from our hos-pital in 2013, of which 3 068 strains in common ward and 984 strains in ICU, were given priority to Bacillus. E. coli, Pseudomonas aeruginosa, Klebsiella pneumoniae and Acinetobacter baumannii were successive in the com-
mon ward, they accounted for 48. 5%. Cocci mainly for Staphylococcus aureus and Enterococcus, accounted for 13. 3%. Acinetobacter baumannii, Pseudomonas aeruginosa, Klebsiella pneumonia, E. coli and Bacillus accounted for 64. 0% in ICU, coccus of Enterococcus and Staphylococcus aureus, accounted for 11. 2%. E. coli, Klebsiella pneumonia and Pseudomonas aeruginosa was separated from general wards had high sensitivity on carbon alkene, a-bove 90. 0%, 80. 0%, 60. 0% respectively, compared to 29. 7% of Acinetobacter baumannii sensitive. Staphylo-coccus aureus separated from general wards of benzene westwood sensitive rate was 54. 7%. E. coli’ s sensitivity to imipenem was 98. 5%, sensitivity rate of Pseudomonas aeruginosa and Klebsiella pneumonia was 50. 0% in ICU, Acinetobacter baumannii drug resistance was serious, only 6. 0%. Acteria genera of benzene westwood sensitive rate was only 33. 3%. It has obvious difference compared with general wards. Conclusion Bacteria distribution and drug resistance of bacteria between ICU and the common wards exist obvious difference, negative bacilli and the re-sistance in the common ward increased significantly compared with ICU. So bacterial drug resistance surveillance on a regular basis in ICU and the whole hospital will help to understand the distribution and drug resistance of bacteria in ICU, so as to guide clinical rational drug use.