ICU医院感染的革兰阴性杆菌的种类及耐药性

The kinds of the Gram-negative bacilli and their resistance to the antibiotics of the nosocomial infections in ICU

目的了解ICU医院感染革兰阴性杆菌的分布及其耐药情况。方法用MicroScan鉴定细菌,K-B法作体外药敏试验,统计,分析ICU革兰阴性杆菌的分布和药敏结果。结果革兰阴性杆菌的分布以铜绿假单胞菌(28.47%)、肺炎克雷伯菌(24.65%)和鲍曼不动杆菌(17.30%)为主。不同系统的感染,其革兰阴性杆菌种类有所差异。铜绿假单胞菌呈多重耐药,尤其对优力新和复方新诺明的耐药率高(分别为92.5%和82.8%)。肺炎克雷伯菌对哌拉西林和头孢唑啉具有较强的耐药性,耐药率分别为82.0%和78.0%。鲍曼不动杆菌对多种抗生素也表现为较高的耐药性,尤其对复方新诺明、哌拉西林和头孢他啶耐药率高,耐药率分别为70.2%、68.7%和65.3%。结论引起ICU医院感染的革兰阴性杆菌均具有较强的耐药性。进行病原菌耐药性监测,根据药敏结果选择敏感抗生素及时控制感染。

Objective To understand the kinds and the distrubution of the Gram-negative Bacilli of nosocomial infections and their resisntance to the antibiotics in ICU. Methods The bacteria were identified by MicroScan, and the susceptibility tests were done accoding to the NCCLS standard. Results The most bacteria including P.aeruginosa(28.47%), K.pneumoniae(24.65%) and A.baumannnii(17.30%). P.aeruginosa were still resistant to some different kinds of antibiotics, and the rates to sulfamethoxazole(82.2%) are high. K.pneumoniae were resistant to piperacilin and cefozolin, with 82.0% and 78.0% respectively. A.baumannnii were resistant to the most antibiotics, especially to cefozolin(68.7%) and ceftazidime(65.3%). Conclusions The resisntant rates to the antibiotics of the pathogenic bacteria in ICU are rather high. It is urgent to establish a survellant system on bacterial. The nosocomial infection should be controlled as far as possible and the antibiotics be chosen accoding to the results of the drugs susceptibility test.