ICU深静脉导管感染的病原菌分布和耐药性分析

目的探讨ICU深静脉导管感染的病原菌分布和细菌耐药性特征。方法对2006年1月—2010年8月ICU送检的342例次深静脉导管标本的细菌培养和药敏试验结果进行分析。结果 342份标本中共检出病原菌101株（29.5%）：革兰阳性球菌、肠杆菌科、非发酵革兰阴性杆菌和真菌分别为29株（28.7%）、25株（24.8%）、33株（32.6%）和14株（13.9%）。病原菌分离率前6位依次为铜绿假单胞菌20株（19.8%）、肺炎克雷伯菌12株（11.9%）、金黄色葡萄球菌10株（9.9%）、表皮葡萄球菌8株（7.9%）、屎肠球菌7株（6.9%）和白色假丝酵母菌7株（6.9%）;金黄色葡萄球菌中MRSA8株占80.0%,凝固酶阴性葡萄球菌中MRCNS7株占63.6%,肠杆菌科细菌中产ESBLs菌株14株占56.O%。分离的病原菌对临床常用抗生素呈现多重耐药。结论 ICU深静脉导管标本检出的病原菌以耐药菌为主,临床微生物实验室应及时准确地报告细菌培养结果和药敏结果,以便指导临床合理使用抗生素。

Investigation of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU

Objective To investigate the characteristics of distribution and drug resistance of pathogenic bacteria causing deep venous catheter related infection in ICU.Methods From January 2006 to August 2010,the culture and drug sensitivity test results of 342 deep venous catheter tip from ICU were analyzed retrospectively.Results Among the results of 342 catheter tip cultures,101 strains(29.5%) of pathogenic bacteria were detected.The proportion of G~+ bacteria,enterobacteria ceae,non-fermentation G~- bacteria and fungi was 29 strains(28.7%),25 strains(24.8%),33 strains(32.6%)and 14 strains (13.9%) respectively.The six most common pathogenic bacteria were pseudomonas aeruginosa 20 strains(19.8%),Klebsiella pneumonia 12 strains(11.9%).Staphylococcus aureus 10 strains(9.9%).Staphylococcus epidermis 8 strains(7.9%),Enterococcus faecium 7 slrains(6.9%) and Saccharomyces albicans 7 strains(6.9%).8 strains(80.0%) of Staphylococcus aureus were MRSA,7 strains(63.6%)of coagulase negative Staphylococci were MRCNS and 14 strains(56.0%) of Enterobacteriaceae were ESBLs.Most isolated strains were multiple drug resistant.Conclusion The most common pathogens cultured from the deep venous catheter tip ill ICU were highly resistant to antibiotics.The clinical micro-organisms laboratory should report the results of bacterial culture and drug susceptibility quickly and accurately for reasonable use of antibiotic drugs in clinical treatment.