重症监护病房抗菌药物应用现状的分析

Status analysis of antibiotic administration in ICU

目的分析重症监护病房(ICU)的主要致病菌及抗菌药物使用情况,为临床治疗提供依据。方法抽取2010年1～3月ICU收治的患者病历23份,从抗菌药物的使用情况及病原学检查等方面进行总体分析评价;从中随机抽取4份病例分析其用药合理性。结果 ICU患者使用的抗菌药物主要有7类,使用最多的是亚胺培南/西司他丁、哌拉西林/他唑巴坦和万古霉素。ICU致病菌主要有革兰阴性杆菌,如铜绿假单胞菌、大肠埃希菌、嗜麦芽假单胞菌及肺炎克雷伯菌;革兰阳性菌主要有溶血性葡萄球菌;厌氧菌与真菌感染也时有发生。结论定期进行病原学检查和细菌耐药动态监测对ICU的感染控制至关重要。

Objective To analyze the major pathogenic bacteria and situation of antibiotic administraton in patients in intensive care unit（ICU） and provide imformation for clinical treatment.Methods 23 medical records of patients in ICU from January to March in 2010 were evaluated by analyzing the situation of antibiotic administraion,and the results of pathogenic examination and 4 cases among them were selected randomly for analyzing the rational antibiotic administration.Results Antibiotics used in ICU patients were involved in 7 categories which the most popular were Imipenem/Cilastatin,Piperacillin/Tazobactam and Vancomycin.The major pathogenic bacteria including Gram-negative bacteria such as pseudomonas aeruginosa,escherichia coli,pseudomonas maltophilia and Klebsiella pneumoniae,Gram-positive bacteria such as haemolytic staphyococus infected ICU patients while infection of anaerobic bacteria and fungal infections had also occasionally occurred.Conclusion Regular examination of pathogen and dynamic monitoring of bacterial resistance are important for infection control in ICU.