2010年医院重症监护室细菌感染监测与分析

目的了解医院重症监护室(ICU)病原菌分布及其耐药情况,为临床诊断与治疗提供依据。方法分析2010年入住重症监护室且有细菌感染的患者资料。结果患者细菌感染率7.83%。在84例感染人次中,以痰液培养为主(占72.62%);感染部位以下呼吸道为主(占70.24%),泌尿道和胃肠道感染各占9.52%。检出的病原菌中,以革兰阴性杆菌为主(占56.25%),其中以鲍曼不动杆菌居多(占24.11%)。鲍曼不动杆菌对抗菌药物的敏感率普遍很低;肺炎克雷伯菌对加替沙星和头孢西丁较敏感,而鲍曼不动杆菌和铜绿假单胞菌对其几乎完全耐药。结论应加强重症监护室细菌耐药监测,了解细菌分布及耐药变化,以利临床合理用药,防止耐药菌株的传播。

Monitoring and Analysis of Bacterial Infection in Intensive Care Unit in 2010

Objective To understand the situation of pathogen distribution and drug resistance in hospital intensive care unit （ICU） for providing evidence to clinical diagnosis and treatment. Methods To analyze the patients admitted to ICU bacterial infection in 2010. Results Infection rate was 7.83%. In 84 cases of infection, sputum culture was the most cases, accounting for 72.62%. Lower respiratory tract infection was the major infection location, accounting for 70.24%, followed by urinary tract and gastrointestinal infections, which accounting for 9.52% in each. In the detected pathogens, Gram-negative bacteria was the most, accounting for 56.25%, in which the Acinetobacter baumannii was the most, accounted for 24. 11%. The sensitive rates of antimicrobial agents against Acinetobacter baumannii are generally low. Gatifloxacin and cefoxitin were sensitive against Klebsiella pneumoniae, but were almost completely resistant to Acinetobacter baumannii and Pseudomonas aeruginosa. Conclusion It is necessary to strengthen ICU monitoring of bacterial resistance, and to understand distribution and changes of bacteria so as to guide clinical drug use of and prevent the spread of resistant strains.