ICU病房医院感染病原菌的调查分析  

Investigation Analysis on Pathogenic Bacterium of ICU Ward

作　　者：戴丽慧 李正军[2] 陈淑兰[3] 宋熙瑶[3] 刘文博[3] 

机构地区：[1]黑龙江省商业职工医院检验科,黑龙江哈尔滨150010 [2]哈尔滨医科大学附属第二医院检验科,黑龙江哈尔滨150086 [3]哈尔滨医科大学附属第一医院微生物科,黑龙江哈尔滨150001

出　　处：《黑龙江医学》2010年第8期612-614,共3页Heilongjiang Medical Journal

摘　　要：目的了解综合性ICU医院感染的流行病学及细菌耐药性,为临床治疗感染性疾病提供可靠的科学依据。方法对我院ICU病房所有临床标本分离的病原菌进行耐药性分析。结果 ICU医院感染中,以G-杆菌为主占86.8%,其次为G+菌占13.2%。G-杆菌中,以产超广谱β-内酰胺酶(ESBL)的肠杆菌科细菌为主占G-杆菌的23.9%,占肠杆菌科细菌总数的71.3%;其次,为铜绿假单胞菌占22.6%。G+菌均为金黄色葡萄球菌,以耐苯唑金黄色葡萄球菌(MRSA)为主占86.5%。G-杆菌中,铜绿假单胞菌对氨曲南的耐药率最高为90%,对头孢他啶的耐药率最低为15%,对亚胺培南的耐药率为19%;ESBL及不动杆菌对亚胺培南的耐药率为0。不动杆菌对头孢哌酮呱酮、头孢哌酮/舒巴坦、氨曲南、哌拉西林、阿莫西林/棒酸、阿米卡星、环丙沙星耐药率最高均为100%,对头孢他啶、头孢吡肟的耐药率也高达88%;ESBL对所有3代头孢菌素及氨曲南均耐药,对含酶抑制剂的复合药阿莫西林/棒酸和头孢哌酮/舒巴坦的耐药率为80%以上,同时对多种抗生素呈交叉耐药。G+菌对11种抗生素的耐药率均在90%以上,对复方新诺明耐药率为16%,只对万古霉素无1例耐药。结论合理使用及严格限定抗生素的应用指证,对延缓细菌耐药性的产生以及个别多重耐药菌株的传播与流行,至关重要。Objective To study on ICU nosocomail infection epidemiology and antibiotic resistance,for the treatment of infectious dieases to provide a reliable scientific basis.Methods ICU ward in our hospital all the pathogens isolated from clinical samples of drug resistance.ICU nosocomial infection.Results In G-negative bacilli in 86.8%,followed by 13.2% G＋ bacteria.G-bacteria,in order to produce extended spectrum β-lactamases（ESBL） Enterobacteriaceae mainly accounted for 23.9% of G-bacteria,Enterobacteriaceae accounted for 71.3% of the total,followed by Pseudomonas aeruginosa accounted for 22.6% G＋ bacteria were Staphylococcus aureus to oxacillin-resistant Staphylococcus aureus（MRSA） accounted for 86.5% of the main.G-bacilli Pseudomonas aeruginosa to aztreonam resistance rate of up to 90%,the lowest resistance to ceftazidime was 15%,to imipenem resistance rate of 19%;ESBL and inactive bacilli resistant to imipenem was 0.Acinetobacter cefoperazone,cefoperazone/sulbactam,aztreonam,piperacillin,amoxicillin/clavulanic acid,amikacin,ciprofloxacin resistance was 100% the highest rate of ceftazidime,cefepime resistance rate as high as 88%;ESBL all third generation cephalosporins and aztreonam were resistant to the drugs with enzyme inhibitors with amoxicillin/clavulanic acid and cefoperazone/Schuba Tanzania more than 80% of the resistance,and were cross-resistant to many antibiotics.G＋ bacteria to 11 antibiotic resistance rate of 90% or more of cotrimoxazole resistance rate was 16%,only none of vancomycin resistance.Conclusion Rational use of antibiotics and strict application of limited indications for delaying the emergence of bacterial resistance and the spread of individual multi-drug resistant strains and the epidemic should be essential.

关 键 词：医院感染 ICU Β-内酰胺酶 耐药性 

分 类 号：R446[医药卫生—诊断学]