371例重症病房感染常见病原菌及其耐药性分析

ANALYSIS OF THE COMMON PATHOGENS AND THEIR DRUG RESISTANCE OF 371 CASES OF INFECTION IN ICU

目的了解我院重症病房常见致病菌感染情况及其耐药性,为病原学调查及临床诊治提供依据。方法采用回顾性调查的方法,对2010年1月～2011年12月汕头市中医医院重症病房细菌感染病例进行分析。结果两年间重症病房检出致病菌为371株;两年间重症病房细菌感染率(33.8%)高于同期医院感染率(8.2%)(p<0.05)。两年致病菌检出率差异显著(p<0.05)。所分离出细菌中以G-杆菌(69.0%)居多,其次为G+球菌(24.5%),其中铜绿假单胞菌和金黄色葡萄球菌为最主要致病菌,G-杆菌对亚胺培南有较高敏感(耐药率31.3%～34.6%),产ESBLs大肠埃希菌的发生率较高(35.9%),耐甲氧西林金黄色葡萄球菌(MRSA)发生率为89.2%。未发现耐万古霉素的G+球菌。结论重症病房感染致病菌多为多重耐药菌株,应对常见病原菌耐药动态加强系统监测,为指导临床科学使用抗生素,减少院内感染提供参考依据。

Objective To investigate the common pathogens and their drug resistance in ICU as an etiologi- cal investigation and provide the basis for clinical diagnosis and treatment. Methods A retrospective investigation method was used to analyze the bacterial infection cases in ICU from 2010 to 2011. Results There were 371 strains of pathogens in ICU during these two years, where bacterial infection rate was 33.8% higher than that in hospital （8. 2% ） inthe same period （p 〈0H05）. There was dramatic significant difference in pathogen detection rates be- tween 2010 and 2011 （p 〈 0. 05 ）. The majority of pathogens were Gram negative bacteria, followed by Gram positive bacteria. Among those the Pseudomonas Aeruginosa and Staphylococcus aureus were the main bacteria. Gram nega- tive bacteria had a high sensitivity to imipenem （resistance rate between 31.3% and 34.6% ）. Incidence of ESBLs in E. coli was high （35.9%） and MRSA was 89.2%. There was no vancomycin resistant Gram positive bacterium. Conclusion The majority of pathogens in ICU were multidrug resistant organisms. Monitoring of the dynamic resist- ance to the common pathogens should be enhanced for the guidance of antibiotic use in order to reduce the nosocomial infection.