ICU患者中颅脑损伤后下呼吸道感染150株病原菌耐药性分析

Bacterial Resistance of 150 Pathogen Strains From the Lower Respiratory Tract Infection of the ICU Patients

目的为掌握我院脑外科ICU下呼吸道感染病原菌的分布情况,确定我院的院内感染菌,了解细菌耐药现状,作此分析报告。方法将我院脑外科ICU2006～2007年下呼吸道感染的病历资料进行统计分析,将各种病原菌的耐药情况进行比较分析。结果 2年收集了90例患者的资料,共检出150株菌,分布于15个属,30个种,革兰阳性菌占8.67%,主要为葡萄球菌和肠球菌。革兰阴性菌占优势,为88.67%,集中在克雷伯杆菌,铜绿假单胞,大肠埃希菌,不动杆菌。真菌检出占2.67%。细菌耐药情况严重,MRSA的检出率为87.25%(7/8),革兰阴性菌的耐药情况也很严重。ESBL的阳性检出率克雷伯杆菌中的占31.58%(12/38),大肠埃希菌中占23.53%(4/17)。结论脑外科ICU下呼吸道感染病原菌的分布较广种类较多,革兰阴性菌占绝对优势,我院院内感染菌为肺炎克雷伯杆菌,铜绿假单胞菌,大肠埃希菌,不动杆菌。细菌耐药性很强,应重视细菌培养和药敏实验,做到合理用药。

Objective To acquaint pathogen distribution of infection and present drug resistance situation of the lower respiratory tract infection of the ICU patients.To figure out the HA pathogen strains in ICU of our hospital.Methods The statistics of the antimicrobial susceptibility testing of all the clinical isolates from 2006-2007in ICU of our hospital conducted.Results Totally 150 bacteria strains were isolated from 90 cases.They were distributed into 15genuses and 30 species.Among them,8.67%were gram-positive bacteria,mainly gathered to Staphylococcus and Enterococcus.88.67% were gram-negative bacteria ,mainly gathered to Klebsilla pneumoniae,25.33%were Pseudomonas aeriginosa,18.67 were Escherichia coli 1,10.67% of which were Acinetobacters. 2.67% were fungus.The drug resistance of the isolates is severe,for the Gram-positive cocci isolated from the clinical issue be The isolates of MRSA is 87.5%.Statistics of drug sensitivity test suggested gram-negative bacilli were highly sensitive to Impenam and Cefoperazone/sulbata The ESBL strains isolates from Klebsilla is 31.58%,from Escherichia coli is 23.53%.Conclusion The pathogen distribution of lower respiratory tract infection of the ICU patients is wide,there are various kind of bacteria.The HA strains in ICU of our hospital are Klebsilla pneumoniae,Pseudomonas aeriginosa,Escherichia coli 1 and Acinetobacters.The drug resistance of the isolates is severe.It is suggested that there be urgent need for surveillance of bacterial resistance and rational use of antimicrobial agents should be emphasized during clinical therapy.