广东某院重症监护病房病原菌及多重耐药菌的分布和变迁

Distribution and change of the pathogens and multi-drug resistant organisms in intensive care unit during 6 years

目的了解汕头大学医学院第一附属医院重症监护病房(ICU)2010-2015年病原菌及多重耐药菌的分布与变迁,为该院医院感染的防控及治疗提供科学的依据。方法应用WHONET5.6、Microsoft Office Excel2007及SPSS19.0统计软件对汕头大学医学院第一附属医院ICU 2010-2015年的病原菌和多重耐药菌的情况进行回顾性分析。结果 ICU病原菌数量呈逐年上升趋势,居于前六位病原菌是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌和白色念珠菌。多重耐药菌以多重耐药鲍曼不动杆菌,多重耐药铜绿假单胞菌,产超广谱β内酰胺酶大肠埃希菌、肺炎克雷伯菌,耐甲氧西林凝固酶阴性葡萄球菌及耐甲氧西林金黄色葡萄球菌为主。多种多重耐药菌6年间差异有统计学意义(P<0.01)。结论 ICU病原菌以医院感染菌为主,病原菌和多重耐药性明显且处于动态变化之中,医师应根据药敏结果合理使用抗菌药物。

Objective To investigate the distribution and changes of pathogens in intensive care unit of our hospital from 2010 to 2015,and provide treatment suggestions for infection.Methods The data of pathogens and multi-drug resistant organisms(MDROs)in ICU from 2010 to 2015 were analyzed retrospectively by WHONET5.6,Microsoft Office Excel2007 and SPSS19.0.Results The numbers of pathogens in ICU were increasing year by year while the top six were Acinetobacter baumanni,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Staphylococcus aureus and Candida albicans.The dominant MDROs were multi-drug resistant Acinetobacter baumanni,multi-drug resistant Pseudomonas aeruginosa,extended spectrumβlactamase producing Escherichia coli and Klebsiella pneumonia,methicillin-resistant coagulase negative Staphylococcus and methicillin-resistant Staphylococcus aureus,etc.There were statistically dramatic significant differences of most MDROs during the six years(P<0.01).Conclusion The pathogens of ICU were mainly bacteria related to the healthcare associated infection,and the multi-drug resistance was obviously in dynamic change as well as most pathogens.As a suggestion,antibiotic agents should be used rationally according to the antimicrobial susceptibility results for treating the MDROs.