医院重症监护病房痰培养金黄色葡萄球菌耐药性的变迁

Change of Drugs Resistance of Staphylococcus aureus in Intensive Care Unit

目的探讨重症监护病房(ICU)患者痰培养中主要病原菌种类、对常用抗菌药物耐药谱等,为临床和医院感染管理提供第一手资料。方法系统分析2001-2006年ICU痰培养中各种细菌的种类以及耐药性的变迁。结果2001-2005年ICU痰培养的细菌以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌分离率为最高,2006年金黄葡萄球菌分离率超过鲍氏不动杆菌;各细菌耐药性呈逐渐增强的趋势,耐甲氧西林金黄葡萄球菌(MRSA)的分离率逐年增加(分别为0、25.0%、29.4%、74.4%、87.7%、92.7%),对多种抗菌药物敏感性下降,仅万古霉素对MRSA全部敏感。结论目前ICU细菌以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌和耐甲氧西林金黄葡萄球菌为主要分离细菌,耐甲氧西林金黄葡萄球菌耐药情况严重,应采取必要措施,控制抗菌药物使用,减少细菌耐药的发生。

OBJECTIVE To get knowledge of the drugs resistance change of Pseudomonas aeruginosa in intensive care unit ICU, so as to offer the first-hand information to the clinical preventive and therapeutic countermeasures. METHODS Antimicrobial susceptibility tests of Staphylococcus aureus（SAU） were performed from 2001 to 2006. RESULTS The most frequent isolates were P. aeruginosa, Klebsiella pneumonia and Acinetobacter baumannii in 2001-2004. S. aureus were more than A. baumannii in 2006 and became the majore isolated bacteria in the sputum of the ICU patients. The incidence of drug resistance increased yearly（0, 25. 0%, 29.4%, 74. 4%, 87.7%, 92.7%, respectively） in S. aureus, and it was susceptibte to vaneomycin. CONCLUSIONS It was showed that P. aeruginosa, K. pneumonia, A. baumannii and S. aureus were the major pathogens in the ICU, showing high drug resistance. Doctors should pay more attention to analyze the bacterial resistance profile in order to decrease the incidence of drug resistance and use the antibiotics properly.