重症监护病房病原菌监测及耐药性分析

Distribution and drug resistance of pathogenic bacteria in intensive care units

目的:了解重症监护病房(ICU)细菌的种类分布和耐药情况,便于指导用药。方法:收集2006年1月到2007年12月ICU病人送检的各种临床标本,进行分析。结果:检出病原菌946株,细菌分布前16位中革兰阴性菌420株(44.4%);真菌254株(26.8%),其中曲霉菌有11株(1.2%);革兰阳性菌134株(14.2%)。大肠埃希菌、肺炎克雷伯菌的产广谱β-内酰胺酶(ESBLS)率分别为24.6%、40.7%。金黄色葡萄球菌中检出MRSA占24.4%,表皮葡萄球菌中检出MRSE占81.2%。重症监护病房(ICU)细菌的种类分布中革兰阴性菌占优势。产广谱β-内酰胺酶(ESBLS)的大肠埃希菌、肺炎克雷伯菌,耐甲氧西林的葡萄球菌在ICU中占相当比例。结论:加强耐药性监测,合理使用抗生素十分重要。

[Objective]To investigate the distribution and drug resistance of pathogenic bacteria in intensive care units(ICU) and give medicine guidance.[Method]Collect and analyze the clinical specimens from ICU patients from January 2006 to December 2007.[Result]In the upper sixteen percent of the 946 pathogenic bacteria strains being detected,there were 420 strains (44.4%) of Gram-negative bacteria,254 strains(26.8%) of Fungus(including llstrains of Aspergillus(1.2%) and 134 strains(14.2%) of Gram - positive bacteria).The isolating rate of strains producing extended - spectrum B - lactamase(ESBLS) is 24.6%and 40.7%respectively for Escherichia coli and Klebsiella pneumoniaeis.MRSA accounted for 24.4%of Staphylococcus aureus and MRSE 81.2%of Staphylococcus epidermidis.Gram - negative bacteria is predominant in ICU among those isolated pathogenic bacteria strains.Escherichia coli and Klebsiella pneumoniae producing ESBLS posses a major of proportion,together with methicillin - resistant Staphylococcus.[Conclusion]It is very important to select antibiotics for the treatment of infections in ICU according to the results of susceptibility tests.