ICU下呼吸道感染者病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria causing respiratory tract infection in patients of ICU

目的探讨医院ICU下呼吸道感染者痰培养病原菌的分布及耐药性。方法回顾性分析医院2008年1月-2010年12月ICU下呼吸道感染者1562份合格痰标本中培养的515株病原菌及耐药性。结果 515株病原菌中,革兰阴性菌325株,占63.1%,革兰阳性菌156株,占30.3%,真菌34株,占6.6%;革兰阴性菌中,鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌分别占18.6%、13.4%、7.0%、6.8%;革兰阳性菌中,金黄色葡萄球菌占16.1%;鲍氏不动杆菌和铜绿假单胞菌的检出率呈逐年上升的趋势,耐药结果显示,大多数抗菌药物的耐药率逐年升高,多药耐药严重。结论医院ICU的感染以革兰阴性菌为主;大部分病原菌呈现高耐药和多药耐药的特点,及时监测病原菌变化及耐药趋势以指导临床用药至关重要。

OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria causing respiratory tract infection in patients of intensive care unit. METHODS A total of 515 pathogenic bacteria were isolated from the 1562 patients in ICU from Jan.2008 to Dec.2010.Drug resistance of the pathogenic bacteria was analyzed. RESULTS The main pathogenic bacteria in ICU were gram-negative bacilli（G-）（63.1%）,of which Acinetobacter baumannii（18.6%）,Klebsiella pneumonia（13.4%）,Pseudomonas aeruginosa（36 cases,accounting for 7.0%）,Escherichia coli（6.8%）.Staphylococcus aureus were the main pathogenic bacteria in gram-positive cocci（16.1%）.Detection rate of A.baumannii and P.aeruginosa were increasing annually.Drug resistance of most antimicrobial agents were also growing up annually and multidrug resistance were worsening. CONCLUSION The study shows that the main pathogenic bacteria are gram-negative bacilli（G-）,including A.baumannii,K.pneumonia,P.aeruginosa,and E.coli.S.aureus are the main pathogenic bacteria in gram-positive cocci and they show high drug resistance.