呼吸与危重症医学科5年医院感染病原学及耐药性分析

Distribution of pathogens causing nosocomial infections and antimicrobial resistance in the past 5 years in respiratory and intensive care unit

目的：了解呼吸与危重症医学科（RICU）近5年医院感染流行病学特点及细菌耐药性。方法对医院呼吸与危重症医学科2009年6月至2014年6月所分离的病原菌分布构成及耐药性进行回顾性分析。结果共分离出病原菌1411株，其中革兰阴性菌为1254株占88.87%，革兰阳性菌共分离出137株，占9.71%。最常见革兰阴性菌为鲍氏不动杆菌554株，占39.26%；最常见革兰阳性菌为屎肠球菌67株，占4.75%。多重耐药革兰阴性菌前3位是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌，检出率分别是36.36%、31.25%、24.83%；革兰阳性球菌对替加环素、万古霉素、替考拉宁及利奈唑胺仍保持较高敏感性。结论革兰阴性杆菌仍为呼吸与危重症医学科医院感染的主要病原菌，且呈多药耐药性特点，应采取行之有效的干预对策，控制细菌耐药性迅速增长的不良趋势。

Objective To investigate the epidemiology characteristics and bacterial drug resistance of hospital-acquired infections in past 5 years in the department of respiratory and intensive care unit. Methods The distribution,composition and drug resistance of the pathogens isolated from clinical specimens from June 2009 to June 2014 were analyzed retrospectively.Results Among 1 41 1 strains of pathogens isolated,1 254 strains （88.87%） were gram-negative bacteria and 137 （9.71%） strains of gram-positive bacteria.Acinetobacter baumannii was the most predominant species of gram-negative bacteria （554 strains,39.26%） and Enterococcus faecium was the most predominant gram-positive bacteria（67 strains,4.75%）.The top three multi-drug resistant strains of gram-positive bacteria were Acinetobacter baumannii,Pseudomonas aeruginosa and Klebsiella pneumonia （36.36%,31.25% and 24.83% retrospectively）.All gram-positive bacteria were highly sensitive to Tigecycline,Vancomycin, Teicoplanin and Linezolid.Conclusions The gram-negative bacteria were the main pathogens causing nosocomial infections in the department of respiratory and critical care medicine and the majority were multi-drug resistant strains.It is necessary to take effective interventions to control the increasing tendency of drug resistance.