462例ICU住院患者感染发生率及病原菌耐药性分析

The Incidence of Infection and Drug Resistance of Pathogens in 462 Inpatients in ICU

目的:分析重症加强护理病房(ICU)住院患者院内感染率及病原菌耐药性。方法:回顾性分析本院2018年1月—2019年4月462例ICU住院患者的临床资料,统计院内感染率,并分析细菌培养及药敏结果。结果:本研究观察患者中,发生院内感染60例,感染率为12.99%。共分离出110株病原菌,其中革兰阴性杆菌(G-杆菌)54株,占49.09%,鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌检出率分别为17.27%、11.82%、9.09%;革兰阳性球菌(G+球菌)44株,占40.00%,金黄色葡萄球菌、表皮葡萄球菌检出率分别为20.00%、10.91%;真菌12株,占10.91%,白色假丝酵母菌检出率为7.27%;G-杆菌、G+球菌对青霉素G、临床三代头孢菌素耐药率高,部分可达100%,而对阿米卡星、头孢哌酮舒巴坦、美罗培南、亚胺培南等较敏感。结论:ICU住院患者院内感染风险较高,病原菌以G-杆菌、G+球菌为主,耐药现象严重,对阿米卡星、头孢哌酮舒巴坦、美罗培南、亚胺培南敏感性较好,可为临床医师经验用药提供参考。

Objective:To analyze the infection rate and drug resistance of pathogens in intensive care unit(ICU).Methods:The clinical data of 462 ICU inpatients in our hospital from January 2018 to April 2019 were retrospectively analyzed.The nosocomial infection rate was counted,and the results of bacterial culture and drug sensitivity were analyzed.Results:In this group of patients,there were 60 cases of nosocomial infection,the infection rate was 12.99%.A total of 110 pathogenic bacteria were isolated,of which 54 were gram-negative bacilli(49.09%),the detection rates of Acinetobacter baumannii,Klebsiella pneumoniae and Pseudomonas aeruginosa were 17.27%,11.82%and 9.09%,respectively;44 strains of gram-positive cocci(G+cocci),accounting for 40.00%,and the detection rates of Staphylococcus aureus and Staphylococcus epidermidis were 20.00%and 10.91%,respectively;and 12 strains of fungi.The detection rate of Candida albicans was 7.27%.The resistance rate of Gbacilli and G+cocci to penicillin G and the number of clinical third generation cephalosporins was high,some of them were 100%,but sensitive to amikacin,cefoperazone sulbactam,meropenem and imipenem.Conclusion:The infection risk of ICU inpatients is high,and the main pathogens are G-bacilli and G+cocci.The drug resistance is serious.The sensitivity of ICU patients to amikacin,cefoperazone sulbactam,meropenem and imipenem is good,which can provide reference for clinical doctors to use drugs empirically.