ICU感染患者病原菌分布的调查  

Distribution of pathogens causing infections in ICU patients

作　　者：黄妍[1] 曾昆[1] 曹好好[2] 

机构地区：[1]华中科技大学附属武汉市普爱医院西院区急诊内科,湖北武汉430034 [2]华中科技大学附属武汉市普爱医院西院区重症监护室,湖北武汉430034

出　　处：《中华医院感染学杂志》2014年第12期2896-2897,2900,共3页Chinese Journal of Nosocomiology

基　　金：湖北省自然基金资助项目(2002AB116)

摘　　要：目的探讨医院重症监护病房(ICU)中感染主要病原菌的分布,为控制医院感染提供依据。方法对2009年2月-2014年2月医院ICU诊治的4 500例患者进行回顾性分析,统计感染者主要病原菌的分布,数据采用SPSS17.0软件进行统计处理,根据卫生部颁布《全国临床检验操作规程》进行常规的分离、培养、鉴定,细菌培养鉴定采用法国生物梅里埃公司VITEK-2Compact全自动微生物鉴定和药敏分析系统。结果 4 500例ICU患者中共发生感染169例,感染率为3.76%;感染患者标本来源以尿液为主占33.14%,伤口分泌物检出最少,占2.96%;共检出病原菌299株,其中革兰阴性菌162株占54.18%,革兰阳性菌85株占28.43%,真菌52株占17.39%,革兰阴性菌中以大肠埃希菌检出最多占13.38%,革兰阳性菌中以金黄色葡萄球菌检出最多占12.04%,真菌以白色假丝酵母菌检出最多占9.03%;共检出多药耐药菌31株,检出率为12.55%,主要是铜绿假单胞菌、鲍氏不动杆菌、大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌。结论针对医院ICU存在的感染,加强医护人员预防控制感染的认识和执行是减少感染的主要途径,同时注意合理使用抗菌药物避免多药耐药菌的产生。OBJECTIVE To explore the distribution of major species of pathogens causing infections in intensive care unit （ICU） so as to provide guidance for control of nosocomial infections .METHODS A total of 4 500 patients who were treated in the ICU from Feb 2009 to Feb 2014 were retrospectively analyzed ,then the distribution of the major species of pathogens was taken for statistics , the routine isolation , culture , and identification were performed by referring to national clinical laboratory procedures issued by the Ministry of Health ,and the bacterial culture and identification were performed by using VITEK-2 Compact automatic microorganism identification and drug susceptibility analysis system of BioMérieux ,France .RESULTS Of the 4 500 ICU patients ,the infections occurred in 169 cases with the infection rate of 3 .76% .The urine specimens were the major specimen sources obtained from the patients with infections , accounting for 12 .04% , and the wound secretions accounted for 2 .96% .Totally 299 strains of pathogens have been isolated ,including 162 （54 .18% ） strains of gram-negative bacteria ,85 （28 .43% ） strains of gram-positive bacteria ,and 52 （17 .39% ） strains of fungi;the Escherichia coli was the predominant species of gram-negative bacteria ,accounting for 13 .38% ;the Staphylococcus aureus was dominant among the gram-positive bacteria ,accounting for 12 .04% ;the Candida albicans was the predominant species of fungi ,accounting for 9 .03% .A total of 31 strains of multidrug-resistant bacteria have been isolated with the isolation rate of 12 .55% ,among which the Pseudomonas aeruginosa ,Acinetobacter baumannii ,Esche-richia coli , K lebsiella pneumoniae , and Staphylococcus aureus were dominant .CONCLUSIONS As for the infections in the ICU ,it is an effective way to strengthen the awareness of infection control of the medical staff and reasonably use antibiotics so as to reduce the incidence of infections and prevent the emergence of multidrug-resistant bacteria .

关 键 词：重症监护病房 感染患者 监测 病原菌 

分 类 号：R378[医药卫生—病原生物学]