2011年ICU患者病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens isolated from the ICU patients in 2011

作　　者：徐凤琴[1] 肖秀红[1] 陈丽容[1] 余静[1] 陈伯宁[1] 卢妤[1] 

机构地区：[1]中山大学孙逸仙纪念医院医院感染管理办公室,广东广州510120

出　　处：《中华医院感染学杂志》2013年第11期2748-2750,共3页Chinese Journal of Nosocomiology

摘　　要：目的调查ICU患者感染的病原菌分布与耐药现状,为临床合理使用抗菌药物提供依据。方法对2011年1-12月ICU送检的痰液、血液等标本2463份进行病原菌培养、分离、鉴定和耐药性分析。结果共分离1625株病原菌,其中革兰阴性杆菌1019株占62.7%,革兰阳性球菌291株占17.9%,真菌315株占19.4%;革兰阴性杆菌排列前5位的依次为嗜麦芽寡养单胞菌、鲍氏不动杆菌、铜绿假单胞菌、洋葱伯克霍尔德菌和肺炎克雷伯菌;革兰阳性球菌排列前3位的依次为金黄色葡萄球菌、凝固酶阴性葡萄球菌和肠球菌属;标本来源较多的是痰液和血液,分别占89.2%、4.5%;产ESBLs大肠埃希菌、肺炎克雷伯菌检出率分别为69.2%和71.1%;铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为49.1%和42.1%,鲍氏不动杆菌耐药严重,对多数抗菌药物的耐药率>60.0%;金黄色葡萄球菌中MRSA检出率为79.1%。结论医院ICU患者以呼吸道感染为主,革兰阴性杆菌所占比例较高,多药耐药性严重,应重视对ICU的病原学检测及药敏分析,合理使用抗菌药物,减少新的耐药菌株出现。OBJECTIVE To study the distribution and drug resistance of pathogens causing infections in the ICU patients so as to provide bacteriological basis for the clinical use of antibiotics. METHODS Pathogens were isolated from 2463 samples of sputum, blood and other specimens obtained from the ICU patients from Jan to Dec 2011, and the drug resistance results were analyzed. RESULTS A total of 1625 isolates were collected, including 1019 （62.7%） strains of gram-negative strains, 291（17.9%） strains of gram-positive strains, and 315（19.4%） strains of fungi. The Stenotrophomonas, Acinetobacter baumannii , Pseudornonas aeruginosa , Pseudomonas cepacia and Klebsiella pneumoniae were the top five species among the gram-negative bacteria, and the Staphylococcus au-reus, coagulase-negative Staphylococcus and Enterococcus spp were the top three species among the gram-positive bacteria. The most common sampling sites were sputum and blood, accounting for 89.2% and 4.5% respectively. The prevalence rates of the ESBLs-producing Escherichia coli and K. pneumoniae were 69. 2% and 71. 1%, respectively. The drug resistance rates of the P. aeruginosa to imipenem and meropenem were 49. 1% and 42. 1%, respectively, and the A. baumannii strains were highly drug resistant; the detection rate of MRSA in the S. aureus strains was 79. 1%. CONCLUSION The respiratory tract infections are the most common in the ICU patients, the gram-negative bacilli are the predominant pathogens, most of the pathogens causing infections are highly drug resistant; it is necessary to focus on the etiological detection and the drug susceptibility testing in the ICU and to reasonably use antibiotics so as to prevent the emergence of the drug resistant strains.

关 键 词：重症监护病房 病原菌 感染 耐药性 

分 类 号：R378[医药卫生—病原生物学]