重症监护病房革兰阴性杆菌分布及耐药分析

An analysis of gram-negative bacillus distribution and resistance in intensive care unit

目的了解本院ICU革兰阴性杆菌的分布及耐药性，为临床合理使用抗感染药提供依据。方法采用美国德灵MicroScanwalkaway96全自动微生物鉴定仪对本院2009年1月至2011年6月ICU患者分离的1472株革兰阴性杆菌进行鉴定及药敏试验。结果我院ICU检出的革兰阴性杆菌以非发酵菌为主，其中铜绿假单胞菌比例为30．0％（442株），鲍曼不动杆菌比例为26．2％（385株）。肠杆菌以奇异变形杆菌、肺炎克雷伯菌、大肠埃希氏菌为主，所占比例分别为11．6％（171株）、6．9％（101株）、5．6％（82株）。各类细菌对常用抗感染药耐药性严重。结论本院ICU检出的革兰阴性杆菌耐药率高，应进行定期监测，为临床合理使用抗感染药提供依据。

Objective To investigate the gram-negative bacillus distribution and resistance in ICU and to provide theoretical bases of rational usage of antibiotics for the clinic. Methods The gram-negative bacillus isolated from patients in ICU collected from 2009 to 2011 were indentified by MicroScan system. Results Nonfermenter was the main in the gram-negative bactillus colleted in our ICU. Among the total, the rate of pseudomonas aeruginosa was 30. 1% and the rate of acinetobacter banmannii was 26. 2%. The majority of enterobacteriaceae were proteus mirabilis, escherichia coli and klebsiella penumoniae （ 11.6% , 6. 9% and 5.6% ）. Most of these bacilli showed multiantibiotic resistance. Conclusions The pathogens in ICU have a high resistant rate to many antimicrobial agents. Periodic survelliance should be done to learn the drug resistance and bacterial distribution in ICU and instruct the clinic to rationally use antibiotics.