重症监护病房病原菌分布及耐药性分析  

Bacterial Distribution and Analysis of Drug Resistance in Intensive Care Unit

作　　者：汪艳[1] 董志扬[2] 梁磊 于志军[1] 孙悦波[1] 

机构地区：[1]大连市友谊医院检验科,辽宁大连116001 [2]大连市友谊医院ICU,辽宁大连116001 [3]大连市第五人民医院骨外科,辽宁大连116001

出　　处：《中华医院感染学杂志》2010年第4期562-563,共2页Chinese Journal of Nosocomiology

摘　　要：目的及时了解和动态掌握重症监护病房(ICU)病原菌分布及耐药趋势,指导临床合理使用抗菌药物。方法对2008年由ICU分离出的807株病原菌进行鉴定和药敏试验,采用WHONET 5.4软件进行统计分析。结果所分离的病原菌以革兰阴性菌为主占77.2%,革兰阳性菌为15.7%,其他真菌等为7.1%;革兰阳性菌中非发酵条件致病菌已经成为ICU的主要病原菌;大肠埃希菌、肺炎克雷伯菌的产超广谱β-内酰胺酶的检出率分别为33.9%和25.9%;革兰阳性菌中以金黄色葡萄球菌、凝固酶阴性葡萄球菌和肠球菌属为主,耐甲氧西林金黄色葡萄球菌(MRSA)、耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为56.9%和70.7%,尚未发现耐万古霉素葡萄球菌和肠球菌属。结论加强ICU感染管理以及病原菌耐药情况的监测,合理使用抗菌药物,降低临床感染的发生率和病原菌耐药率。OBJECTIVE To investigate the bacterial distribution and resistance in ICU infections, and provide basis for clinicais to select antibiotics rationally. METHODS A total of 807 bacteria strains isolated from ICU were identified and tested the drug sensitivity. The results were analyzed using WHONET 5.4 software. RESULTS Of the 807 bacteria strains isolated, 77.2% were Gram-negative bacteria and 15.7% were Gram-positive bacteria. Non-fermentatives were the main species in Gram-negative bacteria. ESBLs positive rates of Echerichia coli and Klebsiella pneumoniae were 33.9 % and 25.9%, respectively. Gram-positive bacteria were Staphylococcus aureus and coagulase-negative Staphylococcus and Enterococcus mainly, meticillin-resistant S. aureus （MRSA） and meticillin-resistant eoagulase-negative Staphylococcus （MRCNS） were 56. 9% and 70. 7%, respectively. No Staphylococcus strain was resistant to vancomycin. CONCLUSIONS We should enhance the management of infection and the monitoring of bacterial resistance in ICU in order to reduce the infection rate in hospital and the resistance rate of bacteria.

关 键 词：重症监护病房 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]