重症监护病房病原菌分布与耐药性分析

Analysis of drug resistance of pathogenic bacteria distribution in intensive care unit

目的研究探讨重症监护病房(ICU)病原菌的分布及耐药情况,为临床合理使用抗菌药物提供科学依据。方法回顾性分析2015年ICU住院患者送检细菌分离培养及药敏试验结果。结果 ICU共送检标本1 326份,分离出病原菌554株,其中革兰阴性病原菌462株(83.4%),革兰阳性病原菌48株(8.7%),真菌44株(7.9%)。革兰阴性杆菌前5位依次为鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、粘质沙雷菌和大肠埃希菌,且多耐药菌株比例较高。革兰阳性病原菌以金黄色葡萄球菌为主,32株(66.7%),MRSA检出率78.3%(25/32)。结论加强重症监护病房的细菌及药敏监测,根据病原菌药敏结果指导临床合理使用抗菌药物,控制耐药菌株的产生,预防及控制院内感染及感染暴发。

Objective To investigate the distribution characteristics and drug resistance of pathogenic bacteria in intensive care unit （ICU）and provide scientific evidence for clinically reasonable use of antibiotics. Methods Specimens from hospitalized intensive care unit patients in 2015 were obtained for routine bacterial isolation and culture. Results A total of 554 bacterial strains were isolated from 1326 specimens,in which Gram-negative bacilli accounted for 462 stains （83.4%）, Gram-positive cocci accounted for 48 stains （8.7%）,and fungi accounted for 44 stains （7.9%）. Gram-negative bacilli of the top five were Acinetobacter baumannii,Pseudomonas aeruginosa,Klebsiella pneumoniae,Serratia marcescens and Escherichia coli,and the rate of multiple resistant bacteria was relatively high.Staphylococcus aureus were the main Gram-positive cocci,including MRSA accounted for 78.3% （25/32）. Conclusion The monitoring of ICU clinical pathogens and their resistance should be strengthened. It is a great significance to use antibiotics rationally according to the results of susceptibility testing,in order to control the occurrence of resistant bacteria ,prevent and control hospital infection and infection outbreak.