ICU感染患者病原菌分布和耐药性分析  

An Analysis of Pathogenic Bacterial Distribution and Drug Resistance in ICU

作　　者：吴勤如[1] 杨翠华[1] 罗君[1] 黄颖桦 

机构地区：[1]广东韶关粤北人民医院检验科,广东韶关512026

出　　处：《实用预防医学》2005年第3期545-547,共3页Practical Preventive Medicine

摘　　要：目的了解重症监护病房(ICU)感染患者病原菌分布和耐药情况,为合理使用抗生素提供理论依据。方法对本院2003年ICU病房510份标本进行培养、分离、鉴定和药敏试验。结果从510份标本共分离出460株病原菌,其中G-杆菌280株,占60.9%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主;G+球菌128株,占27.8%,全部为金黄色葡萄球菌、血清凝固酶阴性葡萄球菌、肠球菌;真菌52株,占11.3%。产ESBLs大肠埃希菌、肺炎克雷伯菌和MR SA、MRCNS的检出率分别为22.2%、36.7%和57.7%、40%。各类细菌对常用抗菌药物表现为严重耐药和多重耐药。在G-杆菌中,铜绿假单胞菌、嗜麦芽窄食单胞菌、不动杆菌对亚胺培南的耐药率达到20%以上;而大肠埃希菌、肺炎克雷伯菌、阴沟杆菌对亚胺培南的耐药率为0.00%。三种G+球菌对万古霉素的耐药率为0.00%。结论通过了解ICU病房病原菌分布和耐药情况,为临床合理使用抗菌药提供依据,从而达到控制感染、减少新的耐药菌株出现的目的。Objective To study the distribution of the bacterial pathgens and drug resistance features in intensive care units （ICU） in a hospital, to provide evidence for reasonable use of antibiotics. Methods Five hundred and ten samples were cultured, isolated, identified and their drug resistances tested. Results A total of 460 pathogenic strains were isolated from the 510 specimens. Escherichia coli, Pseudomonas aeruginosa and Klebsiella pneumonia were the main strains among the 280 isolates （60.9%） which were Gram negative bacilli; and 128 isolates were Gram positive cocci（27.8 % ）, all of which were Staphylococcus aureus, coagulase negative Staphylococcus and Enterococcus; and 52 isolates （11.3%） were Fungus. The isolates producing of extended spectrum beta lactamases （ESBLs） those in Escherichia and Klebsiella pneumoniae were 22.2% and 36.7% respectively; and producing MRSA and MRCNS were 57.7% and 40%. The isolated pathogens showed serious multi drug resistance. The resistant rates of Pseudomonas, Stenotrophornonas maltophilia and Acinetobcter spp to imipenem were greater than 20 %, but not in Escherichia, Klebsiella pneumoniae and Enterobacter cloacae. No resistant of G^＋ cocci to vancomycin was found. Conclusions The pathogenic bacterial distribution and antibiotics susceptibility data provide the evidences that we can select antibiotics reasonably to control the infection and minimize the emergence of new drugresistant bacteria.

关 键 词：ICU 病原菌分布 耐药性 

分 类 号：R372[医药卫生—病原生物学]