ICU感染患者革兰阳性菌的耐药性五年监测分析

Five Years Continuous Monitoring to the Antimicrobial Resistance Among Nosocomial Gram-positive Bacilli from Intensive Care Units

【目的】探讨医院重症监护病房(ICU)感染患者革兰阳性菌的耐药特征。【方法】用 VITEK ATB系统对本院1999至2003年间 ICU患者感染病原菌监测资料进行统计分析。【结果】葡萄球菌对万古霉素、替考拉宁的敏感率为100%,其次对呋喃妥因、呋西地酸、米诺环素和利福平的敏感率分别为99%、90%、89%和87%,敏感率有下降趋势的抗生素是复方磺胺甲基异恶唑(即从2000年的89%降至2003年的22%),对其他抗生素的敏感性在40%以下。肠球菌对青霉素、氨苄青霉素、万古霉素和替考拉宁的耐药率分别为 12%、8%、3%和3%;在所测抗真菌药中,酵母样真菌对制菌霉素的敏感性最高(95%)。【结论】万古霉素、替考拉宁对葡萄球菌仍无耐药性,对肠球菌的耐药性较低,5-年中,酵母样真菌对制菌霉素、5- 氟胞嘧啶和两性霉素 B的敏感性均处于逐年下降的趋势。必须随时监测各病原菌的耐药性,才有助于控制感染。

To investigate the characteristics of antimicrobial resistance among nosocomial gram-positive bacilli from ICU in the hospital.VITEK-ATB system was used to analyze statistically the monitoring data of pathogenic bacteria in ICU patients with infection from 1999 to 2003.The sensitive rate of staphylococcus to vancomycin and teicoplanin was 100%, followed nitrofurantoin(99%),fusidic acid (90%),minocyclineis(89%) and rifampin(87%). The sensitive rate of staphylococcus to trimethoprin/sulfamethoxazole had the trend of descent (declined from 89% in 2000 to 22% in 2003), and activities of other antibiotics were below 40%.Resistance of enterococci to penicillin, ampicillin,vancomycin and teicoplanin was 12%,8%,3% and 3% respectively. The susceptibility of fungus to nystatin was the highest (96%) in the antifungal drugs tested.[Conclusion]The staphylococcus has no drug-resistance to vancomycin and teicoplanin, and the Enterococci spp have lower drug-resistance to them too. In the last five years the sensitive rate of fungi showws trend of descent year by year to nystatin,5-fluorocytosine and amphotericin B.Continuous monitoring antimicrobial resistance of nosocomial organisms showuld be carried out to control infections.