神经内科重症监护病房致病细菌的菌群分析

Analysis of Pathogenic Microorganism in Neurological Intensive Care Unit

目的了解神经内科重症监护病房(NICU)患者医院感染发生情况及病原菌流行病学,提出医院感染控制措施。方法对我院NICU于2002年5月至2004年4月间收治的237例患者分离致病菌的情况及其感染原因进行回顾性分析,共采集并分析326份标本,包括146份痰标本、87份血液标本、46份尿液标本、28份大便标本及19份脑脊液标本。结果326份标本中,有细菌生长324株。其中革兰氏阴性杆菌178株,阳性率54.94%,其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、不动杆菌、阴沟肠杆菌的分离率较高。革兰氏阳性球菌107株,阳性率33.02%,其中金黄色葡萄球菌、肠球菌、凝固酶阴性葡萄球菌的分离率较高。真菌感染39株,阳性率12.04%。常见的感染部位为肺感染和尿路感染。结论加强神经内科重症监护病房的细菌监测,及时发现菌群分布,合理使用抗生素,消除医院内的易感染因素,对有效控制NICU感染十分重要。

Objective To investigate and analyze nosocomial infection incidence and pathogen epidemiology of neurological intensive care unit(NICU) and propose the nursing strategies to reduce the infection rate. Methods Total 237 patients admitted in NICU were enrolled in this retrospective study from May 2002 to April 2004. We analyzed the pathogenic microorganism of 326 samples for the total patients. Results Total 324 bacterium strains were found in 326 samples,including 178 strains of Gram- negative bacillus (54.94%), 107 strains of Gram-positive bacillus (33.02%) and 39 strains of fungus(12.04%). Most of Gram-negative bacilli were Escherichia coli, Klebsislla pneumoniae, Pseudomonas pyocyanea, Acinetobacter baumannii and Enterobacter cloacae. And most of Gram- positive bacilli were Staphylococcus aureus, Enterococcus and Coagulase-negative staphylococci. Pneumonia and urinary system infection were usually found in this study. Conclusion It is important to monitor bacterium, use antibiotics correctly, detect the pathogenic microorganism and prevent risk factors for controlling the infection of NICU.