综合重症监护病房医院感染病原菌分布及其耐药性分析

Distribution of Pathogenic Bacteria Causing Nosocomial Infections in Comprehensive ICU and Drug Resistance Analysis

目的分析综合重症监护病房(ICU)患者医院感染的主要病原菌及其分布特点,以及常用抗生素的耐药性,为临床合理选用抗菌药物提供依据。方法回顾性分析2010年11月-2011年11月宁夏医科大学总医院综合ICU感染病原菌分布及耐药性特点;VITEK32全自动微生物分析仪鉴定菌种并应用K-B法进行药敏试验。结果综合ICU患者医院感染率为17.61%,共检出216株病原菌,其中革兰阴性杆菌占67.60%,位居前三位为鲍曼不动杆菌(24.54%)、铜绿假单胞菌(13.43%)、肺炎克雷伯菌(7.41%);革兰阳性球菌占24.07%,以金黄色葡萄球菌为主,占8.79%;真菌占8.33%,以白色念珠菌为主,占3.70%。革兰阴性杆菌对亚胺培南较敏感;革兰阳性球菌对万古霉素、利奈唑烷敏感,未发现耐药株。结论综合ICU患者医院感染病原菌以革兰阴性杆菌为主,其中鲍曼不动杆菌所占比例较大,耐药率高;临床医生应加强对病原菌分布及耐药性检测,旨在指导科学合理使用抗菌药物,减少新耐药菌株的出现。

Objective To investgate major pathogens in comprehensive intensive care unit( ICU) patients with nosocomial infection and its distribution,as well as resistance to antibiotics commonly used,which will provide evidence for clinical rational use of antibiotics. Metheds The characteristics of pathogens distribution and antibiotic resistance about nosocomial infection in comprehensive ICU from November 2010 to November2011 were retrospectively analyzed. Bacterial species were identificated by VITEK32 automatic microorganisms analyzer while sensitivity tests were completed through method of K-B. Results The nosocomial infection rate was 17. 61% in patients of comprehensive intensive care units( ICU). 216 pathogens were detected and gram-negative bacilli accounted for 67. 60%. The top three of bacteria were Acinetobacter baumannii( 24. 54%),Pseudomonas aeruginosa( 13.43%) and Klebsiella pneumoniae( 7.41%). Gram-positive cocci were 24. 07% and Staphylococcus aureus accounted for 8. 79%. Fungi were 8. 33% and Candida albicans accounted for 3. 70%. Gram-negative bacteria were sensitive to imipenem while Gram-positive cocci were sensitive to vancomycin and linezolid. The resistant strains were not found. Conclusion Gram-negative bacilli were mainly bacterial in comprehensive ICU patients with nosocomial infection. Acinetobacter baumannii took larger proportion and higher drug resistance. Clinicians should enhance detection about pathogen distribution and drug resistance so that scientific and rational use of antibacterial drugs was guided and the emergence of new resistant strains was reduced.