重症监护病房分离细菌病原学分布及其耐药性分析

Bacteria distribution and drug resistance of hospital-acquired nosocomial infection in Intensive Care Unit

目的分析重症监护病房（ICU）细菌感染的病原菌分布,并分析其耐药性。方法收集2015年1-12月安徽省立医院ICU内分离的病原菌并分析其耐药性。结果 855株病原菌中常见革兰阴性杆菌占73.5%,常见革兰阳性球菌占10.1%;阴性杆菌以鲍曼不动杆菌（38.5%）、铜绿假单胞菌（14.5%）、肺炎克雷伯杆菌（12.4%）、大肠埃希菌（7.8%）为主,肺炎克雷伯杆菌、大肠埃希菌产超广谱β-内酰胺酶菌株分别为20.6%、64.2%;阴性杆菌对碳青霉烯类、β内酰胺酶类、阿米卡星等较敏感。阳性球菌主要为金黄色葡萄球菌（3.9%）、肠球菌属（3.6%）、凝固酶阴性葡萄球菌（2.2%）等;耐甲氧西林金黄色葡萄球菌与耐甲氧西林的凝固酶阴性葡萄球菌检出率分别为87.5%和50.0%。结论 ICU分离的病原菌以阴性杆菌为主,且对抗菌药物敏感性差,应加强细菌耐药性的检测,指导抗菌药物运用。

Objective To investigate the pathogen distribution of ICU related bacteria infection,and analyze its pathogen resistance.Methods The retrospective analysis was conducted on distribution and drugresistance profile of pathogens isolated in the ICU from Jan.2015 to Dec. 2015. Results A total of 855 bacteria strains were collected,amongwhich gram negative bacteriaaccounted for 73. 5%andgram positive bacteriaaccounted for 10. 4%. Negative bacteria mainly included Pseudomonas aeruginosa（12. 4%）,Escherichia coli（7. 8%）,Klebsiella pneumoniae（12. 4%） and Bauman Acinetobacter（38. 5%）. The ratio of Klebsiell-a pneumonae producing ESBLs was 20. 6%,Escherichia coli was 64. 2%. Positive cocci included coagulase negative staphylococcus（2. 2%）,Staphylococcus aureus（3. 9%）,Enterococcus（3. 6%） and Streptococcus（0. 8%）. MRSA and MRCNS positive rate was 87. 5% and 50. 0% respectively. Conclusion The bacteria in ICU have significantly multi-drug resistance. The detection of drug resistance bacteria should be strengthened in order to guide an timicrobial drug using to and controlling of nosocomial infection.