2010年河北省三甲医院ICU细菌耐药性监测  

Surveillance of bacterial resistance in ICU of three-A hospitals of Hebei in 2010

作　　者：高伟[1] 冯忠军[1] 孔令茹[2] 孙波[3] 孙艳[2] 孟二荣[4] 张华[5] 刘峰[5] 程敬彬[6] 闫振宇[6] 彭瑞芹[7] 赵文申[7] 柴蒲萍[8] 王晓成[8] 孔令俊[3] 王占国[9] 

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]沧州市中心医院感控科,河北沧州061001 [3]廊坊市人民医院细菌室,河北廊坊065000 [4]廊坊市人民医院体检科,河北廊坊065000 [5]衡水市哈励逊国际和平医院感控科,河北衡水053000 [6]邢台市人民医院感控科,河北邢台054001 [7]邯郸市中心医院感控科,河北邯郸056001 [8]承德市中心医院感控科,河北承德067000 [9]河北大学附属医院感控科,河北保定071000

出　　处：《中华医院感染学杂志》2013年第3期683-685,共3页Chinese Journal of Nosocomiology

基　　金：河北省医学科学研究重点资助项目(20100093)

摘　　要：目的了解2010年河北省三甲医院重症监护病房(ICU)感染病原菌及其耐药性,为临床合理使用抗菌药物提供依据。方法对河北省不同地区8所三甲医院ICU的标本进行菌株分离鉴定,药敏试验采用纸片扩散(K-B)法、MIC法或T-test法,结果判定按照CLSI(2009年版)标准执行。结果共分离出病原菌3161株,革兰阴性菌2521株占79.7%,革兰阳性菌463株占14.6%,真菌177株占5.6%;鲍氏不动杆菌对抗菌药物耐药率低的为多黏菌素B和米诺环素,对其他抗菌药物的耐药率均>52.0%;铜绿假单胞菌对抗菌药物耐药率低的为多黏菌素B和阿米卡星,对其他抗菌药物的耐药率均>38.0%;肠杆菌科细菌对抗菌药物耐药率最低的为亚胺培南和美罗培南,分别为2.1%～4.5%、1.1%～3.1%,其次是头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星;葡萄球菌属对万古霉素、替考拉宁和利奈唑胺均敏感,敏感率为100.0%。结论 2010年河北省三甲医院ICU感染病原菌以革兰阴性菌为主,主要病原菌对抗菌药物耐药严重,应引起重视。OBJECTIVE To understand the distribution and drug resistance of the pathogens causing infections in intensive care unit（ICU） of the three-A hospitals of Hebei in 2010 so as to provide basis for the reasonable use of antibiotics.METHODS The strains of bacteria isolated from eight three-A hospital of Hebei were identified by automatic bacteria system,and the antimicrobial susceptibility testing was performed by Kirby-Bauer test,MIC test and E-test,the standards of CLSI issued in 2009 were used to assess the results of antimicrobial susceptibility.RESULTS A total of 3161 strains of pathogens were isolated,of which the gram-positive cocci,gram-negative bacteria and fungi accounted for 79.7%（2521 strains）,14.6%（463 strains）,and 5.6%（177 strains）,respectively.The Acinetobacter baumannii strains were with low resistance rates to polymyxin B and minocycline,and the resistance rates to other antibiotics were higher than 52.0%.The Pseudomonas aeruginosa strains were with low resistance rates to polymyxin B and amikacin,the drug resistance rates to other drugs were higher than 38.0%.The drug resistance rates of the Enterobacteriaceae strains were lowest to imipenem and meropenem,followed by cefoperazone/sulbactam,piperacillin/tazobactam and amikacin.No Staphylococcus was resistant to vancomycin,teicoplanin,or linezolid.Of the Enterococci.CONCLUSION The gram-negative bacteria are the predominant pathogens causing infections in ICU of the three-A hospitals of Hebei province and are seriously drug resistant,which should be attached great importance to.

关 键 词：重症监护病房 河北地区 病原菌 耐药性 监测 

分 类 号：R378[医药卫生—病原生物学]