重症监护病房病原菌流行菌株及其耐药特点分析  

Prevalent Strains of Pathogens and Drug Resistance Analysis in ICU

作　　者：高伟[1] 郑军廷[2] 

机构地区：[1]河北医科大学第三医院感控科,河北石家庄050051 [2]河北医科大学第三医院妇产科,河北石家庄050051

出　　处：《中华医院感染学杂志》2010年第21期3414-3416,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解ICU病原菌流行菌株及其耐药特点,为临床合理使用抗菌药物、预防和控制感染提供依据。方法对2008年1月-2010年5月,医院ICU送检的各种标本进行细菌培养鉴定及药敏试验,对分离出的病原菌及其耐药情况进行统计分析。结果从送检的各类标本中共分离出349株病原菌,以革兰阴性杆菌为主,占77.9%,其次是革兰阳性球菌占12.9%,真菌占9.2%;主要病原菌依次是鲍氏不动杆菌、铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌、嗜麦芽寡养单胞菌等,分别占22.1%、15.2%、11.2%、6.9%、6.9%、6.3%;主要分布于下呼吸道,占69.3%;鲍氏不动杆菌和铜绿假单胞菌泛耐药菌株检出率分别为7.8%和13.2%;肺炎克雷伯菌、大肠埃希菌产ESBLs株检出率分别为46.2%、50.0%;MRSA检出率为50.0%;主要病原菌对抗菌药物表现为多药耐药和泛耐药,革兰阳性球菌对万古霉素和替考拉宁全部敏感。结论 ICU病原菌流行菌株以革兰阴性杆菌为主,主要分布于下呼吸道,主要病原菌对抗菌药物耐药严重;应动态监测ICU病原菌的流行和耐药情况,规范、合理使用抗菌药物,预防和减少耐药菌株的产生。OBJECTIVE To understand the characteristics of the prevalent strains of pathogens and their drug resistance in intensive care unit （ICU） and provide proofs for the rational use of antimicrobial drugs to prevent and control infections. METHODS During Jan 2008 to May 2010, various samples of bacteria from ICU were underwent a process of germ culture, identification and drug-sensitivity test, the isolated pathogens and their drug resistance were analyzed. RESULTS From the submission of various types of specimens isolated from 349 nonduplicate pathogens, the G bacteria, accounted for 77.9%, followed hy G＋ cocci （12.9%） and fungi （9.2%）. The major pathogens were Acinetobacter baumannii , Pseudomonas aeruginosa , Klebsiella pneurnoniae , Escherichia coli, Staphylococcus aureus, and Stenotrophomonas maltophilia, respectively, 22.1%, 15.2 %, 11.2 %, 6. 9%, 6.9% and 6.3%, mainly distributed in the lower respiratory tract, accounting for 69.3%. The rate of A. baumannii and P. aeruginosa pan-resistant strains were 7.8% and 13.2%; The detection rates of K. pneumonial and ESBLs-producing E. coli strains were 46. 2% and 50. 0%; the 50. 0% MRSA were detected. Major pathogens to commonly used antibiotics were multi-drug resistant and pan-resistant, G＋ cocci were sensitive to vancomycin and teicoplanin. CONCLUSION The pathogens prevalent strains in ICU are Gram-negative bacilli, mainly in the lower respiratory tract, the main pathogens show serious drug resistance to antimicrobial agents. Dynamic monitoring to the prevalence and drug resistance of the pathogens in ICU should be performed to standardize the rational use of antibiotics, to prevent and to reduce the drug resistant strains.

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]