ICU与非ICU病房致病细菌谱及耐药分析

Analysis on profile of bacteria and antibiotic resistance in ICU ward and non-ICU ward

目的了解重症监护病房(ICU)与非ICU病房菌谱情况,对其革兰阴性杆菌耐药率进行比较,为不同病区使用抗菌药物提供实验室依据。方法用VITEK-2和细菌鉴定(API)系统对细菌进行鉴定;采用K-B纸片扩散法进行药敏试验,用WHONET 5.3软件进行数据分析,SPSS 11.5软件进行统计学分析。结果ICU病房排在前5位的细菌分别是铜绿假单胞菌(128株,占22.1%)、洋葱伯克霍尔德菌(59株,占10.2%)、凝固酶阴性葡萄球菌(50株,占8.6%)、金黄色葡萄球菌(39株,占6.7%)、白色念珠菌(37株,占6.4%);非ICU病房排在前5位的分别是大肠埃希菌(358株,占16.4%)、铜绿假单胞菌(296株,占13.6%)、凝固酶阴性葡萄球菌(194株,占8.9%)、肺炎克雷伯菌(188株,占8.6%)、金黄色葡萄球菌(184株,占8.5%);ICU病房铜绿假单胞菌、大肠埃希菌的耐药率明显高于非ICU病房。结论ICU病房以条件致病菌非发酵革兰阴性杆菌为主,且耐药程度明显高于非ICU病房,对ICU病房应该单独进行细菌耐药性监测。

Objective In order to provide the base for choosing antibiotic empirically for each ward, the profile of the bacteria was investigated in the ICU ward and non-ICU ward and compared the rate of the antibiotic resistance to the gram negative bacilli. Methods The bacteria were identified by VITEK-2 and API system. Antibiotic sensitivity test adopted Kirby-Bauer method. Data was analyzed by WHONET 5.3 software and SPSS 11.5. Results The first five organisms in ICU ward were Pseudomonas aeruginosa （ 128 isolates, accounted for 22.1% ）, Burkholderia cepacia （59 isolates, 10.2 % ）, coagulase negative staphylococcus （ 50 isolates, 8.6% ）, Staphylococcus aureus （ 39 isolates, 6.7% ） and Candida albicans （37isolates, 6.4% ）. in non-ICU ward the first five organisms were Escherichia coli （358 isolates, account for 16.4% ）, P. aeruginosa（296 isolates, 13.6% ）, coagulase negative staphylococcus （ 194 isolates, 8.9% ）, Klebsiella pneumoniae （ 188 isolate, 8.6 % ） and S. aureus （ 184 isolates, 8.5 % ）. The antibiotic resistant rates of P. aeruginosa and E. coli from ICU w ard were much higher than those in non-ICU ward. Conclusion Non-fermn, gram negative bacilli, are the main isolates in ICU ward and have more significantly high degree of antibiotic resistant rates than those in non-ICU ward, which are treated difficultly. So the antibiotic resistant rates in ICU ward should be monitored alone.