摘要
目的调查医院重症监护病房(ICU)患者临床感染病原菌的分布及耐药趋势,为临床合理选用抗菌药物提供依据。方法对2005年1月-2006年12月ICU住院患者送检的各类标本中分离出的病原菌采用自动微生物分析仪ATB Expression及配套试剂进行细菌鉴定和药敏试验。结果共分离病原菌1197株,以革兰阴性杆菌为主占64.2%,革兰阳性球菌和真菌比例较高,分别占19.6%和15.8%;革兰阴性杆菌中铜绿假单胞菌居于首位,非发酵菌所占比例较高,除大肠埃希菌(40.9%)外,褪色沙雷菌、肺炎克雷伯菌、鲍氏不动杆菌和阴沟肠杆菌产超广谱β-内酰胺酶(ESBLs)比率均>70.0%;革兰阳性球菌以金黄色葡萄球菌为主,耐甲氧西林金黄色葡萄球菌(MRSA)占93.8%;各类对常用抗菌药物表现为严重耐药和多药耐药;真菌189株,主要为白色假丝酵母菌(4.9%)、光滑假丝酵母菌(4.5%)和热带假丝酵母菌(4.4%),对氟康唑、酮康唑及两性霉素B均敏感。结论ICU患者感染及多药耐药严重,加强耐药性监测,合理使用抗菌药物十分重要。
OBJECTIVE To investigate the tendency of bacterial distribution and drug resistance of pathogens in ICU, then instruct clinical application of antibiotics reasonably. METHODS The identification of bacteria, isolated from patients in ICU from Jan 2005 to Dec 2006, and antibiotic susceptibility by ATB expression were used. RESULTS A total of 1197 pathogens strains were isolated, Gram-negative bacilli, Gram-postive cocci and fungi accounted for 64.2 %, 19.6 % and 15.8 %, respectively. The most common pathogens of them were Pseudomonas aeruginosa （22. 1%）. Except Escherichia coli （40%）, the rate of the ESBL-producing strains of Serratia marcescens, Klebsiella pneumoniae, Acinetobacter baumannii and Enterobacter cloacae were higher than 70%. The most common pathogens of Gram-postive cocci were Staphylococcus. Meticillin-resistant strains of Staphylococcus aureus accounted for 93.8%. Mainly pathogenic bacteria were multi-resistant to some antibiotics. There were 189 strains fungi. And all the fungi were sensitive to amphotericin B, fluconazole and ketoconazole. CONCLUSIONS The infection and multi-drug resistance of pathogens are serious in ICU. It＇s important and urgent to carry out surveillance of bacterial resistance for appropriately using antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第11期1537-1539,共3页
Chinese Journal of Nosocomiology
关键词
重症监护病房
细菌分布
耐药性监测
Intensive care unit
Bacterial distribution
Surveillance of drug resistance
