ICU获得性败血症致病菌的临床分析

Pathogenic bacteria of acquired sepicaemia from the ICU:a clinical analysis

目的:确定ICU获得性败血症致病菌的种类、药敏情况、临床特征及影响预后的因素。方法:对2003年9月至2006年3月ICU收治的各科患者(入科不到24 h死亡、自动出院和转科的患者除外),住ICU期间临床怀疑发生败血症送检血培养或导管标本培养证实的85例92次败血症的病原菌进行回顾性分析。结果:ICU获得性败血症的发病率为9.99%,感染者多存在败血症的易感因素。真菌感染、病程中出现感染性休克及肾衰是影响预后的独立危险因素。致病菌分布和药敏特点:①G-菌分离率最高,以条件致病菌为主;②真菌的分离率明显升高;③耐药率较高。结论:败血症ICU获得性发病率高,真菌感染、病程中出现感染性休克及肾衰是影响败血症预后的独立危险因素。

Objective： To explore the category, drug susceptibility, and clinical features of the pathogenic bacteria of acquired septicemia from the ICU and factors affecting prognosis. Methods： The clinical data of the pathogenic bacteria of septicemia confirmed between September 2003 and March 2006 in ICU were retrospectively analyzed. Results： The attack rate of acquired septicemia was 9.99%. Fungal infection, septic shock and renal failure during the course of disease are independent risk factors affecting prognosis. The distribution and features of drug susceptibility are as follows：① G^- bacteria were the most frequently isolated and the conditioned pathogen was mainly produced; ② The fungus was gradually isolated; ③Drug resistance was high. Conclusion： It is the etiological and clinical features that lead to the high attack rate of ICU acquired septicemia.