重症监护病房患者医院感染病原菌及药敏调查

目的观察重症监护室中重危患者感染的病原菌及其对抗菌药物的敏感性。方法对2008年5月至2009年10月所送检的各类标本培养及药敏结果进行回顾性分析。结果、阳性605株，痰中阳性率最高。G＋菌122株，葡萄球菌属98株，其中β-内酰胺酶阳性93株，药物敏感率利耐唑胺100％，万古霉素98．2％，利福平86．7％，苯唑西林耐药率高达98．9％；G-菌393株，其中铜绿假单胞菌133株，鲍曼不动及鲍曼／溶血不动杆菌106株，阴沟肠杆菌24株，嗜麦芽菌属20株，克雷伯菌属19株，药物敏感率亚胺培南61．6％，氨曲南42．0％，左氧氟沙星38．8％，阿米卡星36．1％，而3、4代头孢菌素耐药率高达70％以上；真菌90株，以念珠菌属为主。结论重症监护室重危患者院内感染的病原菌以呼吸道为主，G-菌多见，亚胺培南、氨曲南敏感性较高，G＋菌对β-内酰胺类药物耐药性很高，但对利奈唑胺、万古霉素、利福平敏感性高。

The analysis of the distribution of pathogen and their characteristics of drug susceptibility in the intensive care units

Objective To analyze the distribution of pathogens and its characteristics of drug susceptibility originating from nosocomial infections in the intensive care units(ICU) ,and to provide evidence for clinical anti-infection treatments. Methods The data of the pathogens and their chug susceptibility characteristics were retrospectively analyzed. Many kinds of samples were collected in ICU from May 2008 to October 2009. Results There were 605 postive strains and the highest postive rate in sputum. The Gram-postive bacteria strains were 122 ,including 98 strains of staphylococcus where postive β-lactamases were 93. The drug susceptibility rate of linezolid, vancomycin and rifampin was 100% ,98. 2% and 86. 7% ,respectively. However,the drug resistant rate of oxacillin was 98.9%. Totallly 393 strains of the Gram-negative bacteria have been found, where pseudomonas aeruginosa, acinetobactor baumannii,enterobacter cloacae, stenotrophomonas maltophilia and klebsiella spp were 133,106,24,20 and 19 strains, respectively. The drug susceptibility rate of imipenem, aztreonam, levofloxacin and amikacin was 61. 6%, 42.0%, 38.8 % and 36. 1%, respectively. But the drug resistant rate of the third and fourth generation cephalosporin was over 70%. 90 strains of fungi were also found. The most common fungi infection was candida. Conclusion The nosocomial infections in ICU occurs mainly in respiratory tract,most infections are caused by gram negative bacilli. Imipenem and aztreonam have greater susceptibility to treat them. Gram positive coccus still plays an important role in nosocomial infections in the ICU and they high level of resist beta-lactamase-producing drugs. But they are susceptive to linezolid,vancomycin and rifampin.