2008-2011年我院急诊ICU病原菌的分布趋势与耐药性监测

目的了解急诊ICU病原菌菌群分布及其耐药性，为指导临床治疗和控制医院感染提供细菌学依据。方法采用回顾性调查的方法，对2008年1月～2011年11月我院急诊ICU收治的571例住院患者临床资料进行统计分析。结果共分离病原菌2047株，阳性率为32．8％。分离病原菌以革兰阴性杆菌为主，共1431株，革兰阳性球菌412株，真菌204株。主要病原菌依次为铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌，其中，产ESBLs的大肠埃希菌104株，产ESBLs的肺炎克雷伯杆菌101株，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）241株，耐甲氧西林金黄色葡萄球菌（MRSA）37株。结论我院急诊ICU病原菌以革兰阴性杆菌为主，大部分细菌对常用抗菌药物表现为高度耐药和多重耐药。加强病原学和耐药性监测，对于指导临床合理应用抗菌药物和预防医院感染具有重要意义。

Monitoring of pathogens distribution and drug resistance in emergency ICU of our hospital from 2008 to 2011 WANG Guoyang

Objective To grasp distribution of pathogenic flora and its drug resistance in emergency ICU, in order to provide bacteriological basis for clinical treatment and hospital infection control. Methods Clinical data of 571 inpatients in emergency ICU of our hospital from January 2008 to November 2011 were analyzed based on method of retrospective survey. Results 2 047 pathogens were isolated, with a positive rate of 32.8%. The majority of the isolated pathogens were Gram-negative bacilli, with a number of 1 431 strains; the rest pathogens were 412 strains of Gram- positive cocci and 204 strains of fungus. The main pathogens were Pseudomonas aeruginosa, Escherichia coli and Klebsiella pneumonia successively. Among them, 104 strains were ESBLs-producing Escherichia coli, 101 strains were ESBLs-producing Klebsiella pneumonia, 241 strains were metbicillin-resistant coagulase-negative staphylococci （MR- CNS） and 37 strains were methicillin-resistant Staphylococcus aureus （MRSA）. Conclusion The predominant emergen- cy ICU pathogens are Gram-negative bacilli. Most of the bacteria are highly resistant to the commonly used antibiotics and multi-drug resistant. Strengthening the etiology and drug resistance monitoring are great significance for guiding clinical rational use of antimicrobial drugs and prevention of nosocomial infection.