某综合医院ICU病原菌分布及耐药性分析

Analysis on distribution and drug resistance of pathogenic bacteria in intensive care wards of a general hospital

目的分析某综合医院重症监护病房（ICU）病原菌分布及其耐药性,为有针对性采取预防措施,合理选用抗生素提供可靠依据。方法对2012年1-12月ICU分离的731株病原菌进行分布及耐药性分析。结果不同送检物中检测到的病原菌数量不同,其中痰液中检测到的菌株数最多,占66.89%,其次为肺泡灌洗液（8.34%）和血液（7.52%）。病原菌主要分布在61~90岁患者。在检测到的病原菌中,革兰阴性杆菌检出率最高,占52.67%;革兰阴性杆菌中铜绿假单胞菌检出率最高,其次为肺炎克雷伯菌和鲍曼不动杆菌;革兰阳性球菌中金黄色葡萄球菌检出率最高,其次为停乳链球菌和粪肠球菌;真菌中白色念珠菌检出率最高,其次为烟曲霉。5株革兰阴性杆菌和5株革兰阳性菌对临床常用抗菌药物,均出现较高的耐药性。结论 ICU病原菌感染以老年人多见,主要以呼吸系统感染为主,其中革兰阴性杆菌感染率较高,不同病原菌对抗生素的敏感性不同,因此临床工作中要对高危人群采取预防措施,并根据药敏结果合理应用抗菌药物。

Objective To analyze the distribution and drug resistance of pathogenic bacteria in an intensive care unit （ICU） of a general hospital,in order to provide a reliable basis for the rational use of antibiotics. Methods From January to December 2012, we separated 731 strains of pathogenic bacteria and analyzed statistically the results of the distribution analysis and drug resistance. Results The numbers of pathogenic bacteria detected in different inspection object were differ- ent,in which the sputum was detected the most, which accounted for 66.89%, followed by bronchoalveolar lavage fluid （8.34%） and b[ood（7.52% ）. Pathogenic bacteria distribution was different in different age groups,mainly distributed in 61 ~ 90 years old patients. The detection rate of Gram - negative bacteria was the highest, accounted for 52.67%, of which the incidence of Pseudomonas aeruginosagram was the highest ,followed by Klebsiella pneumoniae and Acinetobacter bauman- nil. In Gram -positive cocci ,Staphylococcus aureus were the highest ,followed by Streptococcus dysgalactiae and Enterococcus faecalis. The highest incidence of fungus was Candida albicansfungus, followed by AspergiUus fumigatus. Five strains Gram - positive and Gram - negative bacteria were highly resistance to the clinical commonly used antimicrobical agents. Conclu- sion Pathogen infection is common in elder people, mainly in respiratory system with a high infection rate of Gram - nega- tive bacilli. Sensitivity of different pathogenic bacteria to antibiotics are different. Preventive measures for high - risk groups in the clinical work should be taken with reasonable application of antibiotics according to the results of drug sensitivitytest.