重症加强治疗病房细菌耐药监测.docVIP

重症加强治疗病房细菌耐药监测【摘要】 目的 了解重症加强治疗病房(ICU)医院获得性细菌感染的病原菌及耐药情况。方法 对ICU2007年1月至2009年3月所有细菌分离株及其耐药进行监测和分析。结果 细菌总数703株,革兰阴性杆菌69.7%,革兰阳性球菌17.6%,真菌12.5%;革兰阳性菌中,耐甲氧西林金黄色葡萄球菌(MRSA)占金黄色葡萄球菌的99%,耐甲氧西林凝固酶阴性葡萄球菌(MRCN)占凝固酶阴性葡萄球菌94%;革兰阴性菌中,铜绿假单胞菌、嗜麦芽寡养单胞菌、不动杆菌属、大肠埃希菌、粘质沙雷菌、肺炎克雷伯菌、脑膜脓毒金黄杆菌、少动鞘氨醇单胞菌、洋葱伯克霍尔德菌分别占31.4%、18%、13.7%、9.3%、6.5%、6.1%、4.7%、3.6%和2.8%,其他菌占4.1%;亚胺培南、阿米卡星、头孢他啶、环丙沙星对G-菌的敏感率分别为58.8%、53.5%、46.1%和57.5%;万古霉素对MRSA、MRCN及肠球菌属的敏感率均为100%。结论 ICU感染以革兰阴性菌感染为主,细菌耐药率明显升高,监测细菌分布及耐药性变化非常重要。 【关键词】 重症加强治疗病房;医院感染;抗生素;耐药 Nosocomial Bacterial Infection in Comprehensive Intensive Care Unit WANG Shou-jun,ZHAI Ping,WANG Shi-fu,HOU Yun-feng.ICU,Zibo Municipal Central Hospital,Zibo 255036,China 【Abstract】 Objective To establish the prevalence of nosocomial bacterial infection and resistance in a comprehensive intensive care unit(ICU).Methods We retrospectively analyzed all the bacterial isolates in the ICU of our hospital from 2007 to 2009.Results Among all the bacterial isolates(n=703),the percentage of Gram-negative bacilli,Gram-positives and fungi were 69.7%,17.6%,and 12.5% respectively.Meticillin resistant Staphylococcus aureus counted for 99% of Staphylococcus aureus and meticillin resistant coagulase negative Staphylococcus counted for 94% of coagulase negative Staphylococcus.The percentage of Pseudomonas aeruginosa,Stenotrophomonas maltophilia,Acinetobacter spp,Enterococcus spp,Serratia marcescens,Klebsiella pneumoniae,Chryseobacterium spp,Sphingomonas paucimobilis and Burkholderiacepacia accounted for 31.4%,18%,13.7%,9.3%,6.5%,6.1%,4.7%,3.6% and 2.8% of Gram-negative bacilli respectively.The susceptive rate of Gram-negative bacteria to imipenem,amikacin,ceftazidime,ciprofloxacin were 58.8%,53.5%,46.1% and 57.5% respectively.The susceptive rate of meticillin-resistant S.aureus,meticillin resistant coagulase negative Staphylococcus and Enterococcus to vancomycin was all 100%.Conclusion Gram-positives become important pathogens of nosocomial infection.Most pathogens show signifi