重症监护病房患者病原菌的分布及耐药性分析

Analysis of pathogens distribution and drug resistance of patients in intensive care unit

目的:了解重症监护病房(ICU)患者感染病原菌分布及耐药情况,为临床合理用药提供理论依据。方法:美国MicroScan-WalkAway96SI全自动微生物分析仪进行细菌鉴定,纸片扩散法进行药敏试验,WHONET5.4软件进行数据分析。结果:所分离出720株病原菌中,革兰阴性杆菌476株(66.1%),革兰阳性球菌175株(24.3%),真菌69株(9.6%)。前5位病原菌为铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌。亚胺培南对除嗜麦芽寡养单胞菌外的其他革兰阴性杆菌具有较好的抗菌活性;革兰阳性球菌对万古霉素的耐药率为0.00%。结论:加强ICU病房细菌耐药性的监测,对指导临床合理用药,防止耐药菌株的传播具有重要意义。

Objective：To investigate the pathogens distribution and drug resistance of patients in intensive care unit and provide theoretical basis of rational usage of antibiotics for the clinic.Methods：Isolated colonies were identified by MicroScan-WalkAway96SI and sensitivity test abopted Kirby-Bauer method.Data was analyzed by WHONET5.4 software.Results：A total of 720 organisms were collected in the survey period,which included 476（66.1%）Gram-negative strains,175（24.3%） Gram-positive strains and 69（9.6%）fungal strains.Pseudomonas aeruginosa,Acinetobacter,Staphylococcus aureus,Coagulase negative Staphylococcus,and Klebsiella pneumonia were the most common isolates.Imipenem showed good antimicrobial activity against Gram-negative bacilli except stenotrophomonas maitophilia,and the resistances rate of three main Gram-positive coccus to Vancomycin was 0.00%.Conclusion：Monitoring of drug resistance to bacterium in ICU should be strengthened.Bacterial distribution,direct rational drug usage in the clinic can prevent bacterial strain of drug resistance from being transmitted.