重症监护病房革兰阴性杆菌的感染分布与耐药性监测

目的　调查重症监护病房 (ICU)内革兰阴性杆菌的感染分布及其耐药特点。方法回顾总结 2 0 0 3年 1月～ 12月的革兰阴性杆菌的细菌谱、耐药性特点及其临床特征。结果　ICU内感染发生的部位主要为呼吸道 ,占前 3位的革兰阴性杆菌为不动杆菌 (2 2 1% )、铜绿假单胞菌(2 0 1% )和肺炎克雷伯菌 (16 9% ) ;亚胺培南和阿米卡星对常见革兰阴性杆菌保持较高的抗菌活性 ,铜绿假单胞菌对亚胺培南的耐药率最高 (12 1% )。结论　ICU内感染的细菌对三代头孢类抗生素耐药率明显增高 ,在用药过程中应有针对性地联合用药 ,以减少耐药性的产生。

Investigation on bacteriology and drug resistance in infectious disease in intensive care unit

Objective To investigate the bacterial spectrum and drug resistance of gram-negative bacteria infection in intensive care unit(ICU).Methods A retrospective analysis was conducted on flora isolates from Jan 2003 to Dec 2003 to investigate the bacterial spectrum,bacterial resistance and clinical characteristics.Results The leading causative microorganisms isolated were Acinetobacter spp (22.1%),Pseudomonas aeruginosa(20.1%),and E.coli (16.9%). Gram-negative bacteria exhibited the lowest resistance rates to imipenem/cilastati and Amikacin in all antibiotics currently used.However Pseudomonas aeruginosa had the highest resistance rate to imipenem/cilastatin in all the gram-negative bacteria (12.1%).The respiratory tract was the most common compromised site in ICU.Conclusions The causative bacteria in infection in ICU have a higher resistance to antibiotics currently used including cephalosporins of third-generation.It is critical to adopt specific antibiotics based on bacteriology and susceptibility to prevent the development of drug resistance.