重症监护病房院内获得性感染的临床分析  

Clinical analysis on the nosocomial infections in intensive care unit

作　　者：齐志丽[1] 刘培[1] 庄海舟[1] 段美丽[1] 

机构地区：[1]首都医科大学附属北京友谊医院重症监护病房,北京100050

出　　处：《首都医科大学学报》2018年第1期41-44,共4页Journal of Capital Medical University

摘　　要：目的对重症监护病房(intensive care unit,ICU)院内获得性感染的病原菌分布及耐药情况进行分析,为临床抗生素的应用提供依据。方法采用回顾性调查方法,对2015年1月1日至2016年12月31日期间在首都医科大学附属北京友谊医院ICU住院并且发生院内感染的患者送检标本检出病原菌及药敏结果进行分析。结果调查期间院内感染上报共363人次,分离出271例菌株,居前5位的病原菌分别为为肺炎克雷伯杆菌(16.97%)、鲍曼不动杆菌(13.28%)、铜绿假单胞菌(12.18%)、屎肠球菌(10.7%)、金黄色葡萄球菌(5.9%)。居前3位的感染部位分别为下呼吸道(55.7%)、血液(17.6%)、腹部盆腔内组织(9.9%)。2016年较2015年肺炎克雷伯杆菌的发生率明显增加(P<0.05)。结论近两年重症监护病房院内获得性感染的主要部位在下呼吸道,肺炎克雷伯杆菌的发生率明显增加,且呈现多重耐药,需引起重视。Objective The study was conducted to analyze the pathogen division and drug resistance of nosocomial infection in intensive care unit（ ICU）,and to provide advice for the clinical application of antibiotics. Methods A retrospective survey was conducted to analyze the results of pathogens and drug susceptibility test in the patients hospitalized in ICU Beijing Friendship Hospital,Capital Medical University and contracting hospital infection during the period from January 1,2015 to December 31,2016. Results A total of 363 cases were reported during 2 years,out of which 271 strains were isolated. The top 5 pathogens were Klebsiella pneumoniae（ 16. 97%）, Acinetobacter baumannii（ 13. 28%）, Pseudomonas aeruginosa（ 12. 18%）, Enterococcus faecium（ 10. 7%）, and Staphylococcus aureus（ 5. 9%）. The top three infection sites were lower respiratory tract（ 55. 7%）,blood（ 17. 6%）,abdominal pelvic tissue（ 9. 9%）. The incidence of Klebsiella pneumonia in 2016 was significantly higher than that in 2015（ P〈0. 05）. Conclusion During the study period,the most common part of nosocomial infection in ICU was in the lower respiratory tract. The incidence of Klebsiella pneumoniae increased significantly suggesting that antibiotics should be used reasonably,because most of Klebsiella pneumoniae were multi-drug resistant.

关 键 词：重症监护病房 院内获得性感染 病原菌分布 肺炎克雷伯杆菌 

分 类 号：R195[医药卫生—卫生统计学]