2013年同济医院icu病原菌耐药性监测.docVIP

一所教学医院重症监护病房病原及其耐药性分析 刘新明 侯红艳 田磊 陈中举 朱旭慧 管青 作者简介：刘新明（1970.6-），男，主管技师，主要从事糖尿病肾病和输血方面的研究。 作者单位：华中科技大学同济医学院附属同济医院医务处，430030 通讯作者：管青，guanq2000@126.com 摘要：目的 了解2013年重症监护病房（ICU）患者感染常见病原菌的分布及抗菌药物。方法 2013年ICU患者临床分离的1379株非重复细菌，进行分析。 结果 共分离病原菌1379株，革兰阴性菌827株占60%，革兰阳性菌461株占33.4%，真菌91株占6.6%。鲍曼不动杆菌、金黄色葡萄球菌铜绿假单胞菌、凝固酶阴性葡萄球菌肺炎克雷伯菌大肠埃希菌。甲氧西林金葡菌检出率88.4%和88.3%，未发现对万古霉素葡萄球菌株耐万古霉素的屎肠球菌。大肠埃希菌和肺炎克雷菌产ESBLs检出率分别为70%和36%发现株耐碳氢酶烯类的肺炎克雷伯菌铜绿假单胞菌对亚胺培南和美洛培南的耐药率分别为62.3%和60.4%鲍曼不动杆菌对的耐药性分别耐药杆菌检出率达到47.5%。真菌以白念珠菌为主，对5种抗真菌药物耐药率均小于%。血液（16%）、引流液（10%）、尿液（7%） 结论 院ICU细菌耐药现象严重，加强病原学和耐药性监测，临床合理应用抗菌药物和预防医院感染 关键词 ICU；耐药性监测； 抗菌药物 Surveillance of antibacterial resistance in clinical isolates from Intensive Care Unit of one teaching Hospital in 2013 LIU Xinming, HOU Hongyan, TIAN Lei, CHEN Zhongju, GUAN Qing. (Department of clinical laboratory, Tongji Hospital affiliated to Tongji Medical College of Huazhong University of Science and Technology, Wuhan 430030, China ) Abstract: Objective To investigate the distribution and antibacterial resistance in clinical strains isolated from Intensive Care Unit (ICU) of one teaching Hospital in 2013. Method Collect and analyze the 1379 non-respective clinical strains isolated from ICU patients of one teaching hospital in 2013. Results A total of 1379 strains were isolated, including gram-negative bacteria (827, 60%), gram-positive bacteria (461, 33.4%) and fungi (91, 6.6%). The most comman strains were Acinetobacter baumannii (26.4%), Staphylococcus aureus (17.8%), Pseudomonas aeruginosa (11.2%), coagulase-negative Staphylococcus (CNS, 7.5%), Klebsiella pneumoniae (6%), Escherichia coli (5.7%) and Stenotrophomonas maltophilia (5.5.%) and Enterococcus faecium (3.1%). The prevalence of MRSA and MRCNS were 88.4% and 88.3%, respectively. No staphylococcal strains were found resistant to vancomycin, teicoplanin or linezolid. The resistance rates of E. faecalis strains to most tested drugs were much lower than those of E. faecium. Two strain of E. faecium were r