重症监护室革兰氏阳性菌菌谱及其耐药性连续7年监测

A 7-year Surveillance of the Spectrum and Antibiotic Resistance of Gram-positive Strains in Intensive Care Unit

目的:了解我院重症监护室(ICU)分离菌中革兰氏阳性(G+)菌菌谱及其耐药情况,为临床防治G+菌感染提供依据。方法:对ICU7年间所分离到的G+菌及其耐药性进行回顾性调查。结果:共分离获得G+菌242株,占总分离菌数的23.6%(242/1 024)。G+菌分离率在同期分离株中逐年增高(由1998年的14.8%上升到2004的29.1%)。G+菌以金黄色葡萄球菌(SA)为主(60.8%),其次表皮葡萄球菌(SE,15.3%)、溶血性葡萄球菌(10.7%)。耐甲氧西林金黄色葡萄球菌占SA的87.1%,耐甲氧西林表皮葡萄球菌占SE的89.2%。体外药敏试验结果显示主要G+菌均呈多重耐药特性,只有万古霉素对G+菌具有很强的抗菌活性,敏感率达100%。结论:ICU每年G+菌所占比例有逐年增高的趋势。耐甲氧西林葡萄球菌所占比例很高,细菌呈多重耐药特性。我们应高度重视这一严重问题并尽一切可能预防院内感染,并减少多重耐药菌的产生。

Objective： To study the spectrum and antibiotic resistance of gram-positive（G^＋）strains in intensive care unit （ICU）so as to provide the evidences for clinical treatment. Methods： The G^＋ strains isolated from ICU and their drug resistance were retrospectively analyzed. Results： During the past 7 years, there were 242 G^＋ strains in total isolated from ICU. The isolated rate of G^＋ strains was increasing yearly（ 14.8% in 1998 up to 29.1% in 2004）. The most frequent isolate of G^＋ strains was Staphylococcus aureus （SA, 60.8%）, followed by Staphylococcus epidermidis （SE, 15.3%）and Staphylococcus haemolyticus（10.7%）. The percentage of methicillin-resistant SA was 87.1% among SA and that of methicillin-resistant SE was 89.2 % among SE. The antibiotic susceptibility test in vitro showed that the main isolates had very high drag-resistant rate to all antibiotics except for vancomycin. Conclusion： The percentage of G^＋ strains is increasing yearly in ICU during the past 7 years. The main isolates are all multi-drag resistant.