呼吸重症监护病房下呼吸道感染细菌监测的临床调查

The Clinical Survey of the Pathogenic Bacteria Isolated from Lower Respiratory Tract in RICU

目的了解呼吸重症监护病房（RICU）下呼吸道感染病原学分布及抗菌药物耐药性的情况。方法对东台市人民医院RICU自2008年3月-2009年5月所分离170株致病菌的菌群分布以及对抗菌药物耐药性的情况进行回顾性分析。结果 170株病原菌中,G-菌137株。其中铜绿假单胞菌45株（占G-菌32.85%）,位居首位;对常用抗菌药物如头孢他啶、环丙沙星、头孢哌酮/舒巴坦、亚胺培南、哌拉西林/他唑巴坦耐药率分别高达76.19%、79.17%、81.08%、81.58%、88.24%。其他常见的G-菌依次为鲍曼不动杆菌、阴沟肠杆菌、肺炎克雷伯菌、其他假单胞菌等。G＋菌33株,金黄色葡萄球菌32株,对万古霉素和利奈唑烷无一耐药,对SMZ＋TMP的耐药率为10%。结论铜绿假单胞菌、鲍曼不动杆菌、金黄色葡萄球菌是我院RICU下呼吸道感染最主要的致病菌。

Objective To identifying the distribution and drug resistance of pathogenic bacteria isolated from lower respiratory tract（LRT） in RICU.Methods In RICU of Dongtai People,s Hospital,a retrospective analysis on pathogenic bacteria isolated from LRT and drug susceptible test were carried on from March,2008 to May,2009.Result 137 of the 170 strains are gram-negative bacteria.Fist of which is pseudomonas aeruginosa（45 strains）,the resistance rate to ceftazidime,ciprofloxacin,cefoperazone/sulbactam,imipenem,piperacillin /tazobac are 76.19%,79.17%,81.08%,81.58%,88.24%.other gram-negative bacteria are baumanii,enterobacter cloacae,klebsiella pneumoniae,other pseudomonas,et al.33 of the 170 strains are gram-positive bacteria,staphylococcus aureus are 32 strains.There are no drug fast to vancocin and Linezolid,and the resistance rate to SMZ＋TMP is 10%.Conclusion In RICU,the main pathogenic bacteria are pseudomonas aeruginosa、baumanii、staphylococcus aureus.It is valuable for antibacterial selection to evaluate the pathogens and perform microbial sensitivity test timely in clinic work.