重症监护病房院内感染调查分析

目的 :研究重症监护病房院内感染菌群的变迁及细菌耐药的情况 ,为经验性选择抗生素提供依据 ,以达到控制院内感染的目的。方法 :对本院ICU 13 9例患者分离出的 3 10株细菌进行分析。结果 :共分离出革兰阳性 (G+)球菌 64株 ,占总数的 2 0 .6% ;革兰阴性 (G-)杆菌共 178株 ,占总数的 5 7.5 %。G-杆菌中列前三位的分别是铜绿假单胞菌 ( 2 1.6% ) ,肠杆菌 ( 6.8% ) ,大肠艾希菌( 6.5 % )。真菌共 61株 ,占总数的 19.7%。亚胺培南 西拉司丁钠、阿米卡星、头孢他啶对所有的G-杆菌保持着良好的抗菌活性 ,而环丙沙星的敏感率逐年下降。院内感染的发生部位以呼吸道最为常见。结论 :感染的细菌仍以G-杆菌为主。真菌的感染率始终较高 ,并且出现菌种的变异。菌种及细菌药敏的变化使经验性的选择抗生素变得越来越困难。临床医师应尽量减少用药的盲目性 ,以控制耐药菌的产生

Investigation and Analysis of Nosocomial Infection in Intensive Care Unit

Objective: To study the changes of flora and bacterial drug resistance of nosocomial infection in intensive care unit (ICU), in order to provide evidence for empirical application of antibiotics and for the control of nosocomial infection. Methods: A retrospective analysis was carried out among 310 isolates in 139 cases during recent 8 years. Results: The most prevalent isolates of pathogens of nosocomial infection were still gram-negative bacilli ( 57.5%), then gram-positive cocci ( 20.6%) and fungi ( 19.7%). In all bacterial organisms, pseudomonas aeruginosa was the major one ( 21.6%). The resistance rate of gram-negative bacteria to imipenem was the lowest. And respiratory tract was the most common site of nosocomial infection. Conclusion: The infected bacteria are mainly G - bacilli. The fungal infection rate was still high with species variation. The changes of bacterial resistance make it diffcult to choose the antibiotics empirically. For avoiding the production of drug resistant bacteria, it is imperative for clinicians should not use drugs blindly.