| 重症监护病房医院感染病原菌分布及其耐药性分析 |
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| 引用本文： | 戴春梅,周建党,伍勇,漆涌. 重症监护病房医院感染病原菌分布及其耐药性分析[J]. 中南大学学报(医学版), 2006, 31(2): 277-280 |
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| 作者姓名： | 戴春梅 周建党 伍勇 漆涌 |
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| 作者单位： | 中南大学湘雅三医院检验科,长沙,410013;中南大学湘雅三医院检验科,长沙,410013;中南大学湘雅三医院检验科,长沙,410013;中南大学湘雅三医院检验科,长沙,410013 |
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| 摘 要： | 目的：了解重症监护病房（ICU）医院感染病原菌及其药敏特征，为临床抗感染治疗提供依据。方法：对我院2002年至2004年在ICU发生的感染送检标本所分离的细菌及药敏特征进行回顾性分析。结果：ICU的医院感染病原菌以革兰阴性杆菌为多（占48．2％），其次为革兰阳性菌（占43．3％）和真菌（占8．5％）；革兰阴性杆菌以铜绿假单胞菌和大肠杆菌为主，革兰阳性菌以金黄色葡萄球菌为主；革兰阴性杆菌对4种及4种以上的抗生素的耐药率超过40％，耐苯唑西林葡萄球菌对7种常用抗菌素耐药率均在50％以上；大肠杆菌和肺炎克雷伯菌的超广谱β-内酰胺酶（ESBLs）与头孢菌素酶（AmpC酶）检出率分别为34．0％，30．7％和13．2％，23．1％；耐苯唑西林葡萄球菌检出率为66．3％，其对大多数常用抗菌素均显示较高的耐药率（〉55％），与非耐药株有统计学差异。结论：ICU中医院感染虽以革兰阴性杆菌感染为主，但革兰阳性球菌仍是重要的致病菌；抗生素耐药率逐渐升高，且具有高耐药与多重耐药的特点，产ESBLs与AmpC酶是革兰阴性杆菌产生耐药性的重要因素，耐苯唑西林葡萄球菌对抗生素耐药率高。
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| 关 键 词： | 重症监护病房 感染 病原菌 耐药性 |
| 文章编号： | 1672-7347（2006）02-0277-04 |
| 收稿时间： | 2005-07-02 |
| 修稿时间： | 2005-07-02 |
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| DAI Chun-mei,ZHOU Jian-dang,WU Yong,QI Yong.
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| Authors: | DAI Chun-mei ZHOU Jian-dang WU Yong QI Yong |
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| Affiliation: | Department of Clinical Laboratory, Second Xiangya Hospital, Central South University, Changsha, China. dcm_6632@126.com |
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| Abstract: | OBJECTIVE: To determine the distribution of pathogens and their characteristics of drug susceptibility originating from nosocomial infections in the intensive care units (ICU), and to provide evidence for clinical anti-infection treatments. METHODS: Retrospective analysis to the pathogens and their drug susceptibility characteristics was carried out. These pathogens were isolated from the samples that came from patients infected in the ICU from 2002 to 2004. RESULTS: The main nosocomial infective pathogens in the ICU were gram negative bacilli (48.2%), and the next ones were gram positive bacteria (43.3%) and fungus (8.5%). The most common gram negative bacilli were Pseudomonas aeruginosa and Escherichia coli; while for gram positive bacteria, the main bacterin were Staphylococcus aureus. The gram negative bacilli could resist 4 or more than 4 antibiotics, and the rate for resistance exceeded 40%. Similarly, oxacillin resistance staphylococcus could resist 7 antibiotics, and the rate was over 50%. The detective rates of ESBLs and AmpC enzymes produced by Escherichia coli and K. peumoniae were 34.0% & 30.7% and 13.2% & 23.1%, respectively. The rate for oxacillin resistance staphylococcus was 66.3%, and there was relative high resistance rate ( > 55%) for most antibiotics: There was statistical difference, compared with that of non-resistant strains. CONCLUSION: Though gram positive coccus still play an important role, most infections are caused by gram negative bacilli of nosocomial infections in the ICU. The antibiotics resistant rate of all bacteria has been rising gradually. It shows strong resistance and multi-drug resistance. The most importment cause for resistance of gram negative bacilli is that the bacteria can produce ESBLs and AmpC enzymes. The antibiotic resistant rate for oxacillin resistance staphylococcus is really high. |
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| Keywords: | intensive care units infection pathogen resistance |
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