综合性ICU获得性感染的调查分析  

Investigation and analysis on nosocomial infection in comprehensive ICU

作　　者：郑瑞强[1] 杨毅[1] 邱海波[1] 周韶霞[1] 刘少华[1] 高良[1] 

机构地区：[1]南京铁道医学院附属医院,江苏南京210009

出　　处：《中华医院感染学杂志》2000年第1期1-3,共3页Chinese Journal of Nosocomiology

摘　　要：目的　了解综合性 ICU获得性感染的流行病学及细菌耐药性情况 ,为临床防治提供依据。方法　对我院ICU 1996年 4月～ 1998年 4月所有分离的细菌菌株、真菌菌株及细菌耐药性进行回顾性调查。结果　医院获得性感染中仍以 G- 菌为主 4 9.1% ,其次为真菌 3 5 .8%、G+ 菌 15 .1%。在细菌感染中 ,G- 菌占 76.6% ,G+ 菌占 2 3 .4 %。 G- 菌仍以铜绿假单胞菌为主 ,占 3 2 .9%。 G+ 菌以金黄色葡萄球菌 (金葡菌 )为主 69.2 %。金葡菌中耐苯唑青霉素的金葡菌 ( MRSA )占 83 % ,表皮葡萄球菌中耐苯唑青霉素的表皮葡萄球菌 ( MRSE)占 66.7%。真菌以白色念珠菌为主 5 4 .8%。与 1996年 4月～ 1997年 4月所分离菌株相比 ,1997年 4月～ 1998年 4月 G+ 菌由 8.6%增加到 17.5 % ( P<0 .0 1) ,真菌由 2 3 .4 %增加到 4 0 .4 % ( P<0 .0 1) ,而 G- 菌由 68%降低到 4 2 .1% ( P<0 .0 1)。在细菌耐药性方面 ,G- 菌对泰能的耐药率最低为 2 9.4 %。结论　虽 ICU获得性感染中仍以 G- 菌为主 ,但 G+ 菌及真菌已逐渐成为重要致病菌 ,应受到重视 ;获得性感染菌谱的变迁及细菌耐药率升高 ,使临床经验性选择抗生素治疗获得性感染更加困难。OBJECTIVE To search for the prevalence of nosocomial infection and the change of drug resistance in a comprehensive intensive care .METHODS The bacteriai and fungal isolates from ICU and their drug resistance were retrospectively analysd during Apr 1996～Apr 1998.RESULTS The most prevalent isolates of pathogens of nosocomial infection were still Gram negative bacteria(49.1%),then fungi(35.8%) and Gram positive bacteria(15.1%).In all bacterial organisms, Gram negative and G positive bacteria were 76.6% and 23.4% respectively.In Gram negative bacteria Pseudomonas aeruginosa was the major one(32.9%)and in Gram positive bacteria Staphylococcus aureus(69.2%)was most prominent and among the isolated strains MRSA and MRSE were 83% and 66.7%respectively.Candida albicans(54.8%) was the main type of fungi among all the isolated pathogens ,the percentage of Gram positive bacteria increased from 8.6% (in 1996)to 17.5% (in 1998)and fungi also increased from 23.4% (in 1996)to 40.4% (in 1998).But that of Gram negative bacteria decreased from 68% (in 1996)to 42.1% (in 1998).The resistance rate of Gram negative bacteria accounted for emipenem was the lowest(29.4%).CONCLUSIONS Understanding the epidemiologic data and the changes of bacterial resistance profile is the prerequisite to use antibiotics properly,but it is diffecult.

关 键 词：ICU 抗生素 医院内感染 流行病学 

分 类 号：R184.1[医药卫生—流行病学]