我院重症监护病房革兰氏阴性菌谱及其耐药性连续7年的回顾分析  

A 7-year retrospective surveillance of the spectrum and antibiotic resistance of Gram-negative bacilli in our comprehensive intensive care unit

作　　者：余雪涛[1] 刘美描[1] 王佩芬[1] 杨晓燕[1] 

机构地区：[1]汕头大学医学院第一附属医院ICU,广东汕头515041

出　　处：《中日友好医院学报》2009年第2期89-91,94,共4页Journal of China-Japan Friendship Hospital

摘　　要：目的:了解我院重症监护病房(ICU)分离菌中革兰氏阴性(G-)菌谱及其耐药情况,为临床防治G-菌感染提供依据。方法:对ICU2000年1月～2006年12月分离到的G-菌及其耐药性进行回顾性调查。结果:7年间共分离获得G-菌934株,占65.7%(934/1421)。G-菌分离率总的趋势是逐年增多,由2000年48.3%上升到2006年的76.2%。2000年～2003年G-菌前4位分别是肺炎克雷伯氏菌(22.0%)、埃希氏肠杆菌(20.1%)、产气肠杆菌(16.3%)和嗜麦芽窄食假单胞菌(9.5%),而2004年～2006年前4位分别为铜绿假单胞菌(39.0%)、肺炎克雷伯氏菌(21.3%)、鲍曼氏不动杆菌(13.0%)和埃希氏肠杆菌(9.1%)。体外药敏试验结果显示主要G-菌均呈多重耐药特性,现有常用抗生素没有一种对G-菌均具有很强抗菌活性。结论:ICU分离的G-菌有逐年增多趋势,其耐药形势严峻,我们应高度重视并尽可能预防院内感染、减少多重耐药菌的产生。Objective：To get knowledge of the spectrum and antibiotics resistance of Gram-negative（G^-） bacilli in the intensive care unit （ICU）so as to provide the evidence for clinical treatment.Methods：The G^- isolated from ICU and their antibiotics resistance were retrospectively analysed from January 2000 to December 2006. Results：During the past 7 years,there were 934 G^- strains in total were isolated from ICU.The isolation rate of G^- was increasing yearly and that was from 48.3% in 2000 up to 76.2% in 2006.The most frequent isolates of G^- were Klebsiella pneumonia （22.0%）,followed by Escherichia coli （20.1%）,Enterobacter aerogenes （16.3%）and Stenotrophomonas mahophilia （9.5%） from 2000 to 2003.Instead of that,there were Pseudomonas aeruginosa（39.0%）,Klebsiella pneumonia（21.3%）,Acinetobacter baumannii（13.0%） and Escherichia coli（9.1%） from 2004 to 2006.The antibiotics susceptibility test in vitro showed that the main G^- strains were all in multi-drug resistance.Conclusion：The isolated rate of G^- in ICU increased yearly from 2000 to 2006.The conditions of the drug-resistance was very serious.We should pay more attention to this very serious problem and try our best to combat the growing problem.

关 键 词：重症监护病房 革兰氏阴性菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]