急重症监护病房病原菌分布及耐药性分析

BACTERIAL DISTRIBUTION AND ITS DRUG RESISTANCE IN INTENSIVE CARE UNIT

目的了解煤炭总医院2011年急重症监护病房(ICU)的病原菌分布及细菌耐药情况,为临床防治提供依据。方法回顾性分析2011年煤炭总医院ICU病房送检标本中致病菌的检出率及其药敏结果。结果 1 798例送检标本中,共检出183株病原菌,其中革兰阴性菌占61.7%,革兰阳性菌占31.7%,真菌占6.6%;常见病原菌是鲍曼不动杆菌(26.8%)和金黄色葡萄球菌(23.5%)。鲍曼不动杆菌对亚胺培南的耐药率为40.8%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率83.7%,MRSA对万古霉素和利奈唑胺保持敏感,对奎奴普丁-达福普汀的耐药率为12.5%,对其他抗生素都有较高的耐药率。结论多重耐药菌感染是医院ICU常见致病菌感染,应加强ICU感染管理以及病原菌耐药情况的监测,合理使用抗菌药物,降低临床感染的发生率和病原菌耐药率。

Objective To investigate the pathogen distribution and antimicrobial resistance in intensive care unit （ICU） of author＇s hospital, and provide reference for clinical treatment. Methods The positive rate of pathogenic bacteria and drug resistant rate were analyzed retrospectively and data got in 2011 from ICU pa- tients in author＇s hospital. Results From 1798 samples of ICU patients, a total of 183 pathogens were iso- lated. Among those pathogens, gram - negative bacteria accounted for 61.7 %, gram - positive bacteria ac- counted for 31.7 % and fungus accounted for 6.6%. Acinetobacter baumannii（26.8%） ranking the first, followed by Staphylococcus aureus（23.5%）. The resistance of Acinetobacter baumannii to imipenem was of 40.8%. The positive rate of MRSA was 83.7%. MRSA strains were only sensitive to Vancomycin and Linezolid, and the resistance to Quinupristin- dalfopristinand was 12.5%. MRSA were almost resistant to other antibiotics. Conclusion Multi- drug resistant bacteria are the main pathogens of ICU. We should en- hance the management of infection and the monitoring of bacterial resistance in ICU to reduce the infection rate in hospital and the resistance rate of bacteria.