重症监护病房病原菌分布及耐药性分析

Analysis on pathogenic bacteria distribution and drug resistance in ICU

目的了解重症监护病房(ICU)病原菌分布特征与主要病原菌耐药特点。方法收集2016年某医院ICU患者送检标本中病原菌检出情况和药敏试验结果进行分析。结果共收集菌株286株,其中革兰阴性杆菌219株,占76.6%;革兰阳性菌41株,占14.3%;真菌26株,占9.1%。检出病原菌居前5位的依次为鲍曼不动杆菌、铜绿假单胞菌、嗜麦芽糖寡养单胞菌、肺炎克雷伯菌及金黄色葡萄球菌,病原菌主要分离自吸痰标本。鲍曼不动杆菌对亚胺培南及美罗培南耐药率为58.5%和59.6%;铜绿假单胞菌对亚胺培南及美罗培南耐药率为61.0%和58.5%;肺炎克雷伯菌ESBL检出率为96.2%,对碳氢酶烯类耐药率为11.5%。耐甲氧西林的金黄色葡萄球菌(MRSA)检出率为96.0%。结论 ICU病原菌以非发酵革兰阴性杆菌为主,耐药现象严重,应加强ICU院内感染的预防和控制。

Objective To understand the distribution features of pathogen bacterial and the drug resistanceof the main bacteria among them in intensive care unit（ ICU）. Method Analyzing both the information and the results of drug sensitivity test of pathogenic bacteria which were detected in the samples that collected from patients of ICU in one hospital in 2016.Results 286 strains of Nonrepetitive bacteria were collected in total. There were 219 strains of Gram-negative bacilli（ 76. 6%）,41 strains of Gram-positive bacteria（ 14. 3%）,26 strains of fungi（ 9. 1%）. The top 5 strains of bacteria were Acinetobacter,Pseudomonas aeruginosa,Stenotrophomonas maltophilia,Klebsiellapneumoniae and Staphylococcus aureus respectively. The drug resistance rates of Acinetobacter baumannii against imipenem and meropenem were 58. 5% and59. 6%. The drug resistance rates of Pseudomonas aeruginosa against imipenem and meropenem were 61. 0% and 58. 5%.The detection rate of Klebsiella pneumoniae ESBL was 96. 2%,and the resistance rate of hydrocarbons enzyme vinyl was11. 5%. The detection rate of Methicillin-resistant Staphylococcus aureus（ MRSA） was 96. 0%. Conclusion In this study,we found that most pathogenic bacteria were non-fermenting Gram negative bacilli with serious drug-resistance in ICU of the hospital,which suggested that we should improve the awareness to restrain nosocomial infection in ICU.