重症监护病房医院感染病原菌调查及耐药监测

Bacterial Resistance of Pathogens Caused Nosocomial Infection in ICU:Investigation and Surveillance

目的了解2005-2008年重症监护病房(ICU)医院感染病原菌分布及对各类抗菌药物的耐药情况。方法采用纸片扩散法(K-B法)对医院ICU感染患者标本中分离的850株病原菌进行药敏试验。结果850株临床分离菌株中,革兰阴性杆菌占68.9%,革兰阳性球菌占15.8%,酵母菌属占15.3%;产ESBLs大肠埃希菌和肺炎克雷伯菌的检出率分别为50.0%和55.4%,MRS检出率占葡萄球菌属的82.7%;亚胺培南和美罗培南对肠杆菌科细菌、不动杆菌属和铜绿假单胞菌抗菌活性最强,未发现VRE和VRS菌。结论ICU患者以呼吸道感染为主,病原菌以革兰阴性杆菌为主,且多为多药耐药菌,病原菌耐药监测有利于控制医院感染耐药菌的暴发流行。

OBJECTIVE To investigate the distribution and drug resistance of nosocomial infection pathogens in ICU from 2005 to 2008. METHODS Antimicrobial susceptibility test of 850 clinical isolates were carried out by means of K-B method. RESULTS Among 850 isolates, Gram negative bacilli, Gram-positive cocci and fungi accounted for 68.9% ,15.8% and 15.3%, respectively. ESBLs-producing strains accounted for 50% and 55.4% in E. coli and Klebsiella spp. MRS was detected in 82.7% of Staphylococcus. Imipenem and meropenem were the most active agents against strains of Enterobacteriaceae, Acinetobacter spp and Pseudomonas aeruginosa. No VRE or VRS strains were detected. CONCLUSIONS Gram-negative bacilli are the most frequent organisms in ICU. It is necessary to conduct drug resistance supervision of nosocomial infeetion pathogens in ICU and take measures to control nosocomial infection spread.