重症监护病房获得性细菌感染临床调查

Hospital-acquired Bacterial Infection in Intensive Care Unit:A Clinical Investigation

目的对重症监护病房（ICU）获得性细菌感染的标本分布和药物敏感试验进行回顾性分析，为临床合理使用抗菌药物提供依据。方法对2006年1月-2007年12月，从重症监护病房感染患者标本中分离出的病原菌，采用Scepter细菌鉴定仪和API系统进行鉴定，用纸片扩散法进行药物敏感试验，并按美国临床实验室标准化委员会（NCCLS）2006年版标准进行判读。结果分离出病原菌347株，革兰阴性杆菌占68．0％，革兰阳性球菌占20．8％，真菌占11．2％；347株病原菌标本的主要来源：208株来源于呼吸道，87株来源于泌尿道，17株来源于血液。结论重症监护病房感染的病原菌主要存在呼吸道，病原菌以革兰阴性杆菌为主，定期对重症监护病房进行细菌流行病学调查和实行严格的医院感染控制措施极有必要。

OBJECTIVE To study the distribution of samples of bacterial infection in intensive care unit（ICU） and detect their antimicrobial susceptibility, in order to use the antibiotics in clinic rationally. METHODS Bacteria isolated from patients in hospital from Jan 2006 to Dec 2007 were identified by Scepter and API identified tests. Bacterial drug susceptibility test was performed on strains using standard Kirby-Bauer method in accordance with guidelines of NCCLS. RESULTS The most of bacteria resulted in infection in general ICU were Gram-negatives （68. 0%） and then Gram-positives（20.8%）. Fungal infection accounted for 11.2%. Of all 347 pathogens, 208 isolated from respiratory tract, 87 from urinary tract and 17 gained from blood. CONCLUSIONS The most of the bacteria causing infection in general ICU locate in respiratory tract. They are mainly Gram-negatives. So it is urgent to investigate the epidemiology of the bacteria and control the nosocomial infection.