ICU与呼吸科下呼吸道病原菌分布及耐药分析

The distribution and Methicillin-- resistant of pathogenic bacteria at lower respiratory tract infection in intensive care unit（ICU）and respiration department

目的：通过对比某医院重症监护病房（ ICU）与呼吸内科下呼吸道感染致病菌的分离情况及其主要分离菌的耐药性,为临床合理防治提供依据.方法：本文回顾分析某医院2009年6月至2010年6月间发生于ICU与呼吸科送检的致病菌阳性痰标本各100份及致病菌的分布和主要分离菌的耐药性.结果：重症监护室（ICU）痰标本致病菌中铜绿假单胞菌的感染占首位,构成比为37%.而呼吸科痰标本中肺炎克雷伯菌占首位,构成比为31%.同时对其药敏实验结果进行了具体的分析,ICU和呼吸科主要革兰阴性菌对哌拉西林,头孢哌酮/舒巴坦、亚胺培南、头孢他啶、氨曲南的耐药率分别为0～100%,0～94.4%.结论：主要致病菌铜绿假单胞菌,肺炎克雷伯菌等在两个科室之间的耐药性均较高,并且重症监护（ICU）的细菌耐药率普遍高于呼吸科.因此,应加强对致病菌耐药性的监测及防治.

Objective To provide reasonable for clinical prevention and treatm--ent,we compared the distribute of pathogenic bacteria and the Metblcillin-- re--sistant of its main isolated pathogenic bacteria from lower respiration tract in ICU and respiration department in a hospital. Method This article analyze the distribution of pathogenic bacteria of lower respiratory tract infection and the variance of bacteria Methicillin-- resistant from this two department from 2009.6 to 20010.6 Results The top gram negative organisms in ICU wasPseudomonas aeruginosa, but Klebsislla peu-- moniae In respiration department. The medic--ament analysis expressed,The Methicillin-- resistant efficiency of gram negative organisms and gram positive organisms were 0 to 100% in ICU . And the Methicillin- resistant efficiency of gram negative organisms were 0 to 94.4%, and gram posi- tive organisms were 0 to 100% in respiration department . The drugs for gram negative organisms were piperacillin, cefoperazone sulbactam,imipen- era, ceftazidime, aztreonam. The drugs for gram positive organisms were erythromycin ,gentamicin,vancomycin,oxaeillin,penicillin G. Conclusi--ons The main pathogenic bacteria Pseudomonas aeruginosa, Klebsislla peu--moniae,all have high drug resistance. The Methicillin-- resistant of ICU was higher than respiration department.