临床常见细菌和ICU院内感染病原菌分布及耐药性的对比分析

Distribution and drug resistance analysis of clinical and ICU hospital infection bacteria

目的监测临床及ICU院内感染病原菌分布及耐药情况,为控制医院感染提供依据。方法对2008年1~12月住院患者及ICU院内感染患者的各类标本分离细菌进行鉴定和耐药性分析。结果普通病房共分离出病原菌6 024株,ICU院内感染患者分离出病原菌395株。G^-杆菌以铜绿假单胞菌和不动杆菌为主,G^＋球菌以金黄色葡萄球菌和粪肠球菌为主。G^-杆菌对第3、4代头孢菌素耐药率大于39.2%,对头孢哌酮/舒巴坦、亚胺培南、阿米卡星敏感性较好。耐甲氧西林金黄色葡萄球菌多重耐药严重,但尚未发现对万古霉素耐药菌株。G^＋球菌对万古霉素和多西环素均比较敏感。结论医院感染病原菌以G^-杆菌和G^＋球菌为主,这些致病菌对常用抗生素耐药性严重。

Objective To investigate the distribution and drug susceptibility of hospital infection bacteria on the scope of the hospital and also of the ICU unit,and to provide references for effective countermeasures against hospital infection.Methods All the pathogens isolated from the in-patients of the hospital and patients of hospital infection of ICU from January 2008 to December 2008 were identified and analyzed retrospectively.Results There were 6 024 pathogens isolated from the whole hospital,among which there were 395 pathogens from ICU.The most common encountered Gram-negative bacilli were Pseudomonas aeruginosa,followed by Acinetobacter spp.The most common encountered Gram-positive cocci were Staphylococcus aureus,followed by Enterococcus faecalis.The resistant rates of Gram-negative bacilli to the third and forth generations of cephalosporin were above 39.2%,while remained highly sensitive to cefoperazone/sulbactam,imipenem and amikacin.Multiply drug-resistance was severe in methicillin resistant Staphylococcus aureus,but none of vancomycin resistant Staphylococcus aureus was found.Gram-positive cocci were sensitive to vancomycin and vibramycin.Conclusion Gram-negative bacilli and Gram-positive cocci are the major hospital infection bacteria,which show wide resistance to drugs.Consequently,it is essential to detect and monitor the resistant rate of bacilli in order to guide appropriate use of antibiotics.