ICU病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in ICU

目的监测重症监护病房多药耐药菌种类及对抗菌药物耐药性,并探讨控制多药耐药菌的措施。方法对医院2008年1月-2011年1月重症监护病房患者病原菌及抗菌药物敏感性等采取现况调查及采取相应的控制措施。结果下呼吸道分离到病原菌738株,多为多药耐药菌,其中革兰阴性菌占43.90%,真菌占25.21%,革兰阳性菌占30.89%,常见病原菌为真菌、铜绿假单胞菌、金黄色葡萄球菌、克雷伯菌属及奈瑟球菌属,分别占25.21%、17.07%、17.07%、14.23%、13.82%;泌尿道感染共分离出147株病原菌,主要为粪肠球菌、真菌及大肠埃希菌,分别占42.18%、34.01%及23.81%。结论应加强重症监护病房病医院感染监控,重点是呼吸道病原菌的监控,采取相应的预防措施,以控制和减少感染的发生。

OBJECTIVE To monitor the species of multidrug-resistant bacteria in ICU, evaluate the drug resistance, and discuss the measures to control multidrug-resistant bacteria. METHODS The pathogens isolated from the patients in ICU from Jan. 2008 to Jan. 2011 were collected and drug susceptibility testing was performed. Appropriate control measures were adopted. RESULTS A total of 738 pathogens were isolated from lower respiratory tract, most of them were multidrug-resistant bacteria, among which gram-negative bacilli accounted for 43.90 %, fungi accounted for 25.21%, and gram-positive bacteria accounted for 30.89 % ; the common pathogens were fungi, Pseudomonas aeruginosa, Staphylococcus aureus, Klebsiella spp, and Neisseria, accounting for 5.21%, 17. 07%, 17. 07%, 14. 230//00, and 13. 82%, respectively; of 147 strains of pathogens isolated from urinary tract, the predominant pathogens were Enterococcus faecalis, fungi, and Escherichia coli, accounting for 42. 18%, 34. 01%, and 23. 81%, respectively. CONCLUSION It is necessary to strengthen the monitor of nosocomial infections in ICU, focus on the monitoring of pathogens from respiratory tract and adopt appropriate preventive measures, which will benefit to the control and reduction of infections.