重症监护病房呼吸道感染病原菌流行菌株及耐药分析

Prevailing strains of respiratory tract infection in intensive care unit and their antibiotic-resistance

目的:调查分析重症监护病房(ICU)医院呼吸道感染的病原菌流行菌株分布、耐药情况,为危重患者抗感染治疗提供依据。方法:对ICU 2009年1月-2010年12月所分离出的呼吸道标本病原菌菌株及其耐药性进行回顾性调查分析。结果:共检出病原菌549株,其中革兰阴性菌447株(81.4%),以肺炎克雷伯菌、铜绿假单胞菌为主;革兰阳性球菌54株(9.8%),以葡萄球菌属为主;真菌48株(8.7%),以白色假丝酵母菌和光滑酵母菌为主;病原菌对常用抗菌药物耐药严重,且呈多药耐药。结论:ICU医院呼吸道感染以革兰阴性菌为主,对常用抗菌药物耐药严重,且呈多药耐药,需严格掌握抗菌药物使用原则,根据药敏选用抗菌药物。

Objective：To investigate distribution and antibiotics resistance of the prevailing strains isolated from patients with respiratory tract infection in ICU,in order to guide clinical application of antibiotics reasonably.Methods：The antibiotics resistance of pathogenic bacteria isolated from patients with respiratory tract infection in ICUfrom Jan 2009 to Dec 2010 was analyzed retrospectively.Results：Totally 549 bacterial strains were isolated,including 447 strains of gramnegative bacteria（81.4%）,54 strains of Gram-positive bacteria（9.8%）,and 48 strains of fungi（8.7%）.The most common bacteria were Klebsiella pneumoniae and Pseudomonas aeruginosa ingramnegative,Staphy lococcus in Grampositive bacteria and Canidia Albicans and Candida glabrata in fungi,respectively.Pathogenic bacteria demonstrated high drug resistance and multi-drug resistance to common antibiotics.Conclusion：The gram-negative bacteria were the most common bacteria in all pathogenics and showed multi-drug resistance.Therefore,pathogenic bacteria antimicrobial susceptibility test should be strengthened to instruct the use of antibiotics properly in clinic.