重症监护病房患者病原菌分布及其耐药性分析

目的：探讨广州市花都区人民医院重症监护病房（IC U ）近年来病原菌分布情况及对常用抗菌药物的耐药情况。方法对广州市花都区人民医院IC U 2012年2月至2013年2月收集的患者标本进行病原培养及药敏试验，以进行病原学及耐药性分析。结果共675份标本培养出菌株640株，640株菌株以革兰阴性菌为主，共计418株（65．3％），主要为铜绿假单胞菌、鲍曼不动杆菌、肺炎克雷伯菌和大肠埃希菌；革兰阳性菌120株（18．8％），主要为金黄色葡萄球菌、溶血葡萄球菌；真菌102株（15．9％），主要为白色假丝酵母菌。革兰阴性菌对头孢哌酮/舒巴坦均较敏感；革兰阳性菌对万古霉素、替考拉宁高度敏感；真菌对两性霉素B较为敏感。结论 IC U的病原菌分布改变主要表现为真菌比例逐渐升高，而各种病原菌均呈现出广泛耐药性，临床应加强病原菌分布监测，并合理使用抗菌药物以减少耐药菌产生。

Analysis of pathogens distribution and drug resistance of patients in ICU

Objective To investigate the pathogens distribution and drug resistance in intensive care unit （ICU ）of people′s hospital in Huadu district .Methods Collected Patient′s specimens from ICU of this hospital from February 2012 to February 2013 ,the specimens were sented for pathogen culture and sensitivity test for analysis of pathogens and drug resistance .Results 675 samples were collected ,640 strains were cultured ,which was dominated by Gram-negative bacteria totaling 418 strains（65 .3% ） including pseudomonas aeruginosa ,acinetobacter baumannii , klebsiella pneumoniae beth and E .coli;Gram-positive bacterias were 120 strains（18 .8% ） ,including staphylococcus aureus ,staphylococcus haemolyticus mainly ;fungi were 102 strains（15 .9% ） ,including candida albicans mainly .Gram negative bacterias were more sensitive to cefoperazone /sulbactam ,and escherichia coli ,klebsiella pneumoniae were highly sensitive to imipenem ;Gram-positive bacterias were highly sensitive to vancomycin ,teicoplanin ;fungi were more sensitive to amphotericin B .Conclusion Changes of pathogen distribution of ICU mainly lie in increasing ratio of fungi ,but most pathogens show widely resistant to antibiotics ,so clinical monitoring of pathogen distribution should be strengthened ,rational use of antibiotics should reduce resistant bacteria .