重症监护病房下呼吸道感染病原菌的分布及耐药性分析

The distribution and drug resistance of pathogens causing lower respiratory tract infections in the intensive care units

目的探讨引起荆州市中心医院重症监护病房患者下呼吸道感染的病原菌流行趋势、耐药特点和特殊耐药菌分布规律。方法以无菌方式吸取ICU病房医院获得性肺炎患者的下呼吸道标本,然后以常规方法分离病原菌并进行药敏试验,再用WHONET 5.6和SPSS 15.0软件分析相关数据。结果 2007年1月至2011年12月从该院ICU病房患者的下呼吸道标本中共分离各类病原菌共2019株,其中革兰阴性杆菌1 904株,革兰阳性球菌62株,真菌53株。肠杆菌科细菌对β-内酰胺类抗生素普遍耐药,非发酵细菌呈现多重耐药性。结论导致该院ICU病房医院获得性肺炎的病原菌主要是革兰阴性杆菌,其对多种常用抗菌药物的耐药率均较高,可能与抗生素选择压力有关。

Objective To investigate the prevalence trends,drug resistance and special distribution of the pathogens causing lower respiratory tract infection in the intensive care units（ICUs）.Methods Lower respiratory tract specimens were collected from the hospital-acquired pneumonia patients in ICUs by aseptic method from January 2007 to December 2011.The pathogenic bacteria were detected by conventional method and antimicrobial susceptibility test were performed.All data was analyzed by WHONET 5.6 and SPSS 15.0.Results 2019 strains of pathogens were isolated from the lower respiratory tract specimens,among which there were 1 904 Gram-negative bacilli,62 Gram-positive cocci and 53 Fungi.Enterobacteriaceae was generally resistant to β-lactam antibiotics;non-fermenting bacteria showed multi-drug resistance.Conclusion Gram-negative bacilli are the major pathogen causing hospital-acquired pneumonia in ICUs,and show high rates of resistance to a lot of antibiotics,which may be due to the antibiotic selection pressure.