ICU机械通气患者院内感染细菌耐药性分析

Resistance Analysis of Nosocomial Pathogens in Patients with Undergone Ventilation in Intensive Care Unit

目的探讨重症监护病房（ICU）机械通气患者院内感染细菌分布特点及耐药情况。方法回顾性总结2007年5月~2009年5月该院ICU 121例院内感染患者的临床资料、感染病原菌谱及耐药性,并对相关因素进行分析。结果121例感染患者共分离出细菌163株,以G-杆菌为主（占73.01%）,G＋菌比例较低（占16.56%）。G-杆菌中铜绿假单胞菌占第一位（22.7%）,其次为肺炎克雷伯菌（17.79%）、大肠埃希菌（15.34%）。G＋菌主要为金黄色葡萄球菌,其中耐甲氧西林金黄色葡萄球菌占3.68%。此外真菌占10.43%。结论机械通气患者院内感染的病原菌以G-杆菌为主,病原菌显示多重耐药,G-杆菌对亚胺培南和氨曲南敏感性较好,而G＋菌对万古霉素敏感,应根据药物敏感试验选择抗生素。

Objective To investigate the distribution of pathogens and their antibiotic resistance in patients who underwent ventilation in intensive care unit.Method The clinical data,bacterial spectrum and drug resistance of the patients were analyzed retrospectively from May 2007 to May 2009.Results A total of 121 pathogens was identified from the sputum in 163 patients.The rate of gram-negative bacteria and gram-positive bacteria were 73.01% and 16.56% respectively.The most common pathogens of gram-negative bacteria in low respiratory tract were pseudomonas aeruginosa（22.7%）,Kopneumoniae（17.79%）,E.coli（15.34%）,and among gram-positive bacteria strains the Stphylococus aeruginosa was the prominent and MRSA was 3.68%,and the fungi were 10.43%.Conclusion The main pathogens of nosocomial infection in patients who underwent ventilation was G-negative bacilli,the mainly bacilli showed multi-drug resistant,and G-negative bacilli to a better sensitivity to aztreonam and Imipenem,while the G-positive bacteria sensitive to vancomycin,antibiotic selection should be based on sensitivity.