2016—2018年黄山首康医院重症监护室感染性疾病病原菌分布及耐药性分析

目的 探究2016—2018年黄山首康医院重症监护室感染性疾病病原菌分布及耐药性。方法 选取黄山首康医院重症监护室2016年1月—2018年10月收治的病原菌检出阳性感染性疾病患者151例，对病原菌种类、分布情况和主要革兰阳性菌、革兰阴性菌的耐药性进行分析。结果 共检出病原菌222株，其中真菌47例（21.17%），主要为白假丝酵母；革兰阳性菌26例（11.71%），主要为金黄色葡萄球菌、溶血性葡萄球菌及屎肠球菌；革兰阴性菌149例（67.12%），主要包括肺炎克雷伯菌、鲍曼不动杆菌、大肠埃希菌及铜绿假单胞菌；甲氧西林敏感金黄色葡萄球菌（MSSA）对万古霉素、替考拉宁、利福平、环丙沙星、复方磺胺甲唑的耐药率较低，对红霉素、青霉素和氨苄西林的耐药率较高。甲氧西林耐药金黄色葡萄球菌（MRSA）对万古霉素、替考拉宁和复方磺胺甲唑耐药率较低，对环丙沙星和庆大霉素的耐药率较高，对红霉素、青霉素和氨苄西林几乎完全耐药。肺炎克雷伯菌对阿米卡星、亚胺培南、美罗培南和哌拉西林/他唑巴坦的耐药率较低，对头孢噻肟、头孢唑啉和氨苄西林的耐药率较高；鲍曼不动杆菌对多黏菌素的耐药率较低，对其他抗菌药物均表现出较高的耐药性。大肠埃希菌对阿米卡星、亚胺培南、美罗培南、哌拉西林/他唑巴坦的耐药率较低，对头孢噻肟、头孢唑啉和氨苄西林的耐药率较高。结论 2016—2018年黄山首康医院重症监护室感染性疾病病原菌分布广泛，医生应给予细菌培养重点关注，选择合理有效的抗菌药物。

Analysis of distribution and drug resistance of pathogenic bacteria of infectious diseases in intensive care unit of Huangshan Shoukang Hospital from 2016 to 2018

Objective To explore the distribution and drug resistance of pathogenic bacteria in infectious diseases in the Department of Critical Care Medicine, Huangshan Shoukang Hospital from 2016 to 2018. Methods From January 2016 to October 2018, 151 patients with pathogenic bacteria admitted to the ICU were selected for patients with positive infectious diseases. The species, distribution, and resistance of major Gram-positive and Gram-negative bacteria were analyzed. Results 222 Strains of pathogens were detected, in which fungi (47 strains) accounted for 21.17%, and main of them were Candida albicans. Gram-positive bacteria were 26 strains (11.71%), and main of them were Staphylococcus aureus, Staphylococcus haemolyticus, and Enterococcus faecium. Gram-negative bacteria were 149 strains (67.12%), and main of them were Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, and Pseudomonas aeruginosa. The resistance rates of methicillin-sensitive S. aureus (MSSA) against vancomycin, teicoplanin, rifampicin, ciprofloxacin, and compound sulfamethoxazole were lower. The resistance rates against erythrocin, penicillin, and ampicillin were higher. Methicillin-resistant S. aureus (MRSA) was sensitive to vancomycin, teicoplanin, compound sulfamethoxazole, while resistant to ciprofloxacin and gentamicin, and almost completly resistant to erythrocin, penicillin, and ampicillin. K. pneumoniae was more sensitive to amikacin, imipenem, meropenem, and piperacillin tazobactam, and the resistance rates against cefotaxime, cefazolin and ampicillin were higher. A. baumannii was highly sensitive to polymyxin and exhibits high resistance to other antibiotics. E. coli was very sensitive to amikacin, imipenem, meropenem, and piperacillin/tazobactam, and the resistance rate against was cefotaxime, cefazolin, and ampicillin was higher. Conclusion The pathogens of infectious diseases in intensive care unit of Huangshan Shoukang Hospital from 2016 to 2018 are widely distributed. Doctors should give priority to bacterial culture and choose reasonable and effective antibacterial drugs.