ICU病房呼吸道感染痰培养病原菌的分布与耐药性分析

Distribution and drug resistance of the pathogenic bacteria cultured from the phlegm of patients with respiratory tract infection in ICU ward

目的了解医院ICU病房呼吸道感染患者痰培养病原菌的分布及耐药性特点，为医院ICU病房合理使用抗菌药物提供依据。方法回顾性分析2007年至2009年ICU病房送检的所有痰标本细菌培养和药物敏感试验结果。结果分离的菌株中，革兰氏阳性菌占27．3％，革兰氏阴性菌占60．5％，真菌占12．2％。未发现耐万古霉素的金黄色葡萄球菌和肠球菌。肠杆菌科细菌对亚胺培南高度敏感，主要非发酵菌对亚胺培南、阿米卡星、头孢吡肟、头孢哌酮／舒巴坦的耐药率也有所上升。结论ICU病房呼吸道感染患者痰标本分离菌符合近年来临床病原菌的变化趋势：病原菌以革兰氏阴性菌为主，病原菌的耐药率有上升趋势，对指导临床ICU病房合理使用抗菌药物具有重要意义。

Objective To understand the distribution and drug resisitance of pathogenic bateria cultured from the phlegm of patients with respiratory tract infection in ICU ward and provide basis for rational antibacterial administration in ICU ward. Methods To analyse the results of germiculture and drug sensitivity tests for the phlegm sample sended by ICU ward in 2007 -2009. Results Of the isola- ted pathogens, gram negative [ G （superscript （ -）] strains accounted for 60.5% and gram positive strains [ G（superscript ＋ ） ] occupied 27.3% , fungi accounted for 12.2%. Staphylococcus aureus and enterococcus which can resist vancomycin had not been discovered. The bacteria of enterobacteriaceae were most sensitive to imipenem. The resistance rate of main non - zymogen bacteria to imipenem, amikacin, cefepime, sulbactam and cefopcrazone had rised in some measure. Conclusions The isolated bacteria from phlegm sample of patients with respiratory tract infection in ICU ward according with the change trend of clinic pathogenic bateria in these years ： pathogenic bateria are mainly gram negative [ G （ superscript - ） ] strains, their resistance rate present escalating trend. It was important for rational antibacterial administration in ICU ward.