SICU病房感染病原菌流行情况调查及耐药性分析

Prevalence and Drug Resistance Analysis of Pathogens Infection in Surgical Intensive Care Unit Ward

目的:分析2009年至2012年楚雄州医院SICU病房引起感染的病原菌及其耐药情况,为临床合理使用抗菌药物提供帮助。方法:采用法国梅里埃VITEK-2全自动细菌鉴定仪,对4年间楚雄州医院SICU病房培养的病原菌进行鉴定及药敏试验,并利用WHONET5.6软件进行统计分析。结果:4年间SICU病房共检出临床感染病原菌893株,其中革兰阳性菌141株,占15.7%,革兰阴性菌752株,占84.2%。这些菌株分别来自痰、尿、血液、胆汁等,以痰标本多见。在检出细菌中,多重耐药菌株分离率2009年22.1%,2010年30.9%,2011年47.5%,2012年54.3%。从药敏结果看,SICU病房中分离病原菌对常用抗菌药物的耐药率较高,但未发现对碳青霉烯酶类抗生素耐药的肠杆菌科细菌及耐万古霉素肠球菌。结论:医院SICU病房中的感染病原菌多以革兰阴性杆菌为主,多重耐药菌株比例较高,且多重耐药菌株分离率呈逐年上升趋势,应加强区域性细菌耐药监测,以指导临床用药。

Objective： To investigate the prevalence and drug resistance of pathogens infection in surgical intensive care unit （SICU） ward in the Hospital of Chuxiong Prefecture from 2009 to 2012, and to provide help for rational clinical use of antibacterial drugs. Methods： Pathogenic bacteria cultured in SICU from 2009 to 2012 were identified and conducted the drug sensitive test by applied automatic bacteria identification system （biomerieux France）; data were statistically analyzed by WHONET 5.6 software. Results： There were 893 strains of pathogens detected in the 4 years, with 141 strains of gram-positive bacteria （15.7%） and 752 strains of gram-negative bacteria. Pathogens were isolated from samples of sputum, urine, blood and bile, while sputum sample made up the majority. The isolated rate of multi-resistant bacterium was 22.1% （2009）, 30.9% （2010）, 47.5% （2011）, 54.3% （2012）, respectively. Under the drug sensitive test, the rate of pathogen resistance to normal antibacterial drugs was high, but the enterobacteriaceae and vancomycin resistant enterococci resistant to carbon penicillium effect of enzyme antibiotics were not found. Conclusion： The pathogen in SICU was mainly gram-negative bacteria, and with high proportion of multi-resistant bacterium, isolated rate of multi-resistant bacterium raised year by year, we should strengthen the regional surveillance of bacterial resistance to guide clinical medication.