SICU医院感染病原菌分布及耐药性分析

目的 了解外科重症监护病房(SICU)医院感染的病原菌分布及其耐药性,为临床防治提供依据.方法 对2005年1月-2010年12月SICU医院感染的情况进行回顾性分析.结果 共分离出病原菌335株,革兰阴性杆菌占65.7％,以铜绿假单胞菌为主,革兰阳性球菌占23.3％,以凝固酶阴性葡萄球菌为主,真菌占11.0％；肺炎克雷伯菌和大肠埃希菌的超广谱β-内酰胺酶菌株检出率分别为42.0％和43.3％；耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌检出率分别为50.0％和56.4％；非发酵菌严重耐药；肺炎克雷伯菌和肠杆菌科细菌对碳青霉烯类抗菌药物保持高度敏感；替考拉宁、万古霉素和利奈唑胺对革兰阳性球菌具有高抗菌活性.结论 SICU医院感染的耐药问题严重,合理应用抗菌药物和及时掌握病原菌的耐药性变化,是有效控制医院感染的关键.

Distribution and drug resistance of nosocomial pathogens from surgical intensive care unit

OBJECTIVE To investigate the distribution and drug resistance of nosocomial pathogens in the surgical intensive care unit(SICU).METHODS The prevalence of nosocomial infection was surveyed retrospectively in SICU from Jan.2005 to Dec.2010.RESULTS Of the 335 culture-confirmed isolated strains,65.7% of them were gram-negative,23.3% of them were gram-positive and 11.0% were fungi.Pseudomonas aeruginosa and coagulase-negative Staphylococci were the most frequent gram-negative and gram-positive organism,respectively.42.0% of the Klebsiella spp.and 43.3% Escherichia coli were tested positive for extended-spectrum β-lactamase.50.0% of the Staphylococcus aureus and 56.4% of the coagulase-negative Staphylococci were methicillin-resistant.With regard to the gram-negative isolates,both of the Klebsiella spp.and Enterobacteriaceae were still susceptible to carbapenems while the non-fermenters were seriously resistant to most antibiotics.Teicoplanin,vancomycin as well as linezolid had high antibacterial activity against gram-positive cocci.CONCLUSION The drug resistance is serious in SICU,rational use of antibiotics as well as constant surveillance for change of drug resistance especially of those drug-resistant pathogens is essential to control nosocomial infection effectively.