ICU院感脓毒症人群病原菌检测、耐药性及预后分析

The pathogen detection,drug resistance and prognostic analysis in patient with nosocomial sepsis in ICU

目的:通过对ICU院感脓毒症患者病原菌检测、耐药性及预后分析,为临床合理用药和控制院感提供科学依据。方法:回顾性分析206例ICU院感脓毒症患者的临床资料。结果:感染者以有基础性疾病的老年人、长期用药、病情危重、接受侵入性检查与治疗的患者居多;感染部位以呼吸道、泌尿道、导管相关性疾病感染为最多见;共分离病原菌394株,常见病原菌主要是G-杆菌190株(铜绿假单胞菌为主),其次是G+球菌118株(金黄色葡萄球菌为主)、真菌86株(白色假丝酵母菌为主);常见病原菌耐药性较高;预后主要影响因素是重视并加强临床护理及心血管、呼吸、泌尿、血液、消化、神经等多系统、多脏器功能障碍等。经临床综合治疗,采取有效预防和护理措施,改善预后。结论:由于ICU院感脓毒症患者常见病原菌耐药性较高,应根据药敏试验结果合理用药;有效预防和护理措施及心血管、呼吸、泌尿、血液、消化、神经等多系统、多脏器功能障碍等是影响其预后主要因素,临床应积极防治并加强护理,改善预后。

Objective：To detect the pathogen,analyze the drug resistance and prognosis situation in patients with nosocomial sepsis in ICU and provide scientific basis for clinical drug use.Methods： Clinical information of 206 patients with sepsis in ICU was carried out retrospective analysis.Results： Most infectors were elder patients with basic diseases and patients undertaken long-term administration,critical diseases,invasive examination and treatment.Most infection sites were respiratory tract,urinary tract and catheter-related infection.394 pathogens were isolated from 206 patients.The common pathogens were mainly 190 gram negative（G-） bacteria,followed by 118 G＋ cocci and 86 fungi strains.Common pathogens had high resistance.The main prognostic factors were clinical care and dysfunction of cardiovascular,respiratory,urinary tract,blood,digestive and neural systems.Conclusion： Due to the high drug resistance of common pathogens,rational drug use should be based on drug sensitive test results.Effective prevention and care measures and cardiovascular,respiratory,urinary,digestive,nervous,blood and multiple organ dysfunction are the main factors affecting the prognosis.