ICU病房近三年病原菌调查分析

lnvestigation of pathogenic bacterium in ICU during the past three years

目的调查分析ICU病房病原菌种类及耐药状况。方法对我科2003年1月1日至2005年12月31日患者标本分离的病原菌及其耐药特点每年分析比较。结果病原菌347株,2003年90株,2004年149株,2005年108株,其中2003年G-细菌占63.33%(57/90),G+细菌占26.67%(24/90),真菌占10.00%(9/90);2004年G-细菌占70.47%(105/149),G+细菌占18.12%(27/149),真菌占11.41%(17/149);2005年G-细菌占39.81%(43/108),G+细菌占34.25%(37/108),真菌占25.93%(28/108)。G+杆菌:2004年1株,2005年3株;2005年有1株耐万古霉素肠球菌。在3年检出的大肠埃希菌和肺炎克雷白杆菌中产ESBLs菌株分别为0%(0/8)、20.00%(5/25)、42.86%(6/14)。结论重症监护病房G+细菌感染趋势增加,G-细菌感染趋势下降,真菌感染逐年增加,G+细菌感染的种类出现多样化,耐甲氧西林葡萄球菌占感染葡萄球菌比例逐年增高,G-致病菌中肠杆菌科占优势,但致病力弱的菌种开始成为感染的病原菌。

Objective To investigate the source and antibiotic resistance of pathogenic bacterium in intensive care unit. Methods To analyze and compare and December,31 characteristic and antibiotic resistance of pathogenic bacterium isolated from specimens during 2003-2005 year by year. Results 347 strains were isolated,of which 90 strains for 2003, 149 strains for 2004,108 strains for 2005. In the 2003 year, Gram negative bacteria accounted for 63.33%（57/90）,Gram positive bacteria accounted for 26.67%（24/90）,fungus accounted for 10.00%（9/90）; in the 2004 year,Gram negative bacteria accounted for 70.47%（105/149）, Gram positive bacteria accounted for 18.12%（27/149）,fungus accounted for 11.41%（17/149）; in the 2005 year,Gram negative bacteria accounted for 39.81%（43/108）,Gram positive bacteria accounted for 34.25%（37/108）,fungus accounted for 25.93%（28/108）. Gram positive bacillus： 1 strain for 2003,3 strains for 2005 ; 1 strain of vancomycin-resistant enterococcus for 2005; Strains conferred by ESBL of Escherichia and klebsiella pneumoniae were isolated during 3 years were 0%（0/8）,20.00%（5/25）,42.86%（6/14） respectively. Conclusion In intensive care unit, infective tendency of Gram positive bacteria is increasing,infective tendency of Gram negative bacteria is descending, infection of fkmgus is increasing year by year, source of strains of Gram positive bacteria diversifying,Methicillin-resistant Staphyloclccus of infected staphylococci is increasing year by year,the main strains of Gram negative pathogenic bacterium were Enterobacteriaceae,but strains with weak pathogenicity start is becoming infected pathogenic bacterium.