神经外科ICU医院内感染病原菌分布及耐药性分析

Neurosurgery ICU Nosocomial Infection Pathogen Distribution and Drug Resistance

目的:分析我院神经外科ICU患者医院内感染的病原菌分布、耐药性现状,指导临床抗生素使用。方法:对我院神经外科ICU2009年1～12月住院病人医院内121例感染患者资料进行回顾性调查分析。结果:121例患者中有26例发生医院内感染,发生率为21.5%,其中以肺部感染率最高,为65%,且多重反复感染,共检出134株菌株,病原菌以G菌为主,共81株(占60.5%),铜绿假单胞菌(25.9%)、大肠埃希氏菌(22.2%)、鲍曼不动杆菌(16.0%)、嗜麦芽窄食单胞菌(7.5%)。G^+菌38株(占28.4%),粪肠球菌(28.9%)、金黄色葡萄球菌(8%)。检出真菌15株,感染比例为11.2%,白色念珠菌(73.3%)。结论:在神经外科ICU院内感染中,病原菌以G菌为主,对抗菌素耐药严重,且多重耐药(%),G菌、G^+菌对抗菌素敏感性高的分别为亚胺培南和万古霉素。同时要加强医院感染监测,规范抗菌素的合理应用,严格无菌操作,降低院内感染。

Objective： To investigate the distn＇bufion of pathogens and drug-resisitance features in neurosurgery ICU patients of our hospital in recent years, and provide the basis for clinical treatment. Methods：The data of neurusurgery ICU patients with nosoeomial infection in our hospital from Janaary to December 2009 were retrospectively analyzed. Results：Among 121 patients, 26 （21.5%） cases were nosocomial multiple recurrent infections, the highest infection rate of which was in lung （65%）. 134 pathogenic sWains were detected, and there were 81 strains of Gbacteria （60.5%）, mainly including Pseudomonas aeruginosa（25.9%）, Escherichia coli（22.2%）, Acinetobacter baumannii（l 6.0%）, Stenotrophomonas maltophilia（7.5%）; 38 strains of G^＋ bacteria （28.4%）, mainly including feces bacteria Enteroeoccus（28.9%）, Staphylococcus aureus（8%）; 15 strains of fungi （11.2%）, mainly including Candida albicans（73.3%）. Conclusion：The main pathogens are Gbacteria in nosocomial infections ofneurosurgery ICU, the antibiotic resistance of which is severe and multi-drug resistant. The imipenem and vancomycin,high are hypersensitive to G^＋bacteria and G^＋ bacteria respectively. We should strengthen the hospital infection surveillance, and standardize rational application of antibiotics, and strictly execute the asepsis operation to reduce nosoeomial infectious.