重症监护治疗病房细菌感染分布及耐药性分析  

Distribution of pathogens and resistance of infection in ICU.

作　　者：曹文[1] 孙自镛[2] 熊志刚[2] 

机构地区：[1]武汉大学基础医学院病原生物学系 [2]华中科技大学同济医学院附属同济医院检验科,武汉430030

出　　处：《华中医学杂志》2007年第1期19-21,共3页Central China Medical Journal

摘　　要：目的 了解重症监护治疗病房（ICU）感染病原菌分布及耐药特点，为临床合理使用抗菌药物提供参考。方法 对同济医院ICU2004年1月～2005年12月送检标本所分离的细菌及耐药特征进行回顾性分析。结果 共分离病原菌473株，革兰阴性杆菌占71．9％，主要为铜绿假单胞菌和鲍曼不动杆菌；革兰阳性球菌占28．1％，以金黄色葡萄球菌为主。大肠埃希菌和肺炎克雷伯菌的超广谱β-内酰胺酶（ESBLs）检出率分别为30．0％和46．0％。多数革兰阴性杆菌对多种抗菌药物耐药率超过40．0％；多数对亚胺培南及美洛培南保持较高的敏感率。甲氧西林耐药株分别占金黄色葡萄球菌和凝固酶阴性葡萄球菌的76．5％和72．4％。革兰阳性球菌对万古霉素和替考拉宁最敏感。结论 ICU病房呼吸道感染的发生率较高，且以条件致病菌为主。大部分病原菌呈现高耐药和多重耐药的特点。定期对ICU病房进行细菌流行病学调查和耐药分析极有必要。Objective To determine the distribution of pathogens of bacterial infection and their characteristics of drug resistance in intensive care unit （ICU） to provide reference for rational use of the antibiotics in clinical practice. Methods Retrospective analysis on the pathogens and their drug resistant characteristics was carried out. These pathogens were isolated from the samples of the patients infected in the ICU of Tongji Hospital from Jan. 2004 to Dec. 2005. Results Total of 473 strains pathogens were isolated. The Gram-negative bacilli accounted for 71.9%. The most common of them were Pseudomonas aeruginosa and Acinetobacter baumannii. The gram-positive cocci accounted for 28. 1% and the main bacterin was Staphylococcus aureus. The detective rate of ESBLs produced by Escherichia coli and Klebsiella pneumoniae was 30. 0% and 46. 0% respectively. The majority of Gram-negative bacilli could resist many antibiotics, and the rate for resistance exceeded 40.0%. Gram-negative bacilli showed high susceptibility to imipenem and meropenern. MRSA and MRCNS counted for 76. 5% and 72.4% of gram-positive pathogens, respectively. Gram-positive cocci were most susceptible to vancomycin and teicoplamin. Conclusion The incidence of respiratory infection is high in ICU and the dominant pathogen is conditional pathogen. The majority of pathogens show strong resistance and multi-drug resistance. So it is urgent to investigate the epidemiology of the bacteria and monitor their characteristics of drug resistance.

关 键 词：重症监护治疗病房 耐药性 抗菌药物 

分 类 号：R515[医药卫生—内科学]