摘要
目的了解我院重症监护病房(ICU)和普通病房病原菌分布及其耐药性现状,为临床合理用药和医院感染预防控制提供依据。方法对我院2008年1月至2010年12月各类标本中分离出的病原菌类型、分布及药敏结果进行统计分析。结果 2008年1月至2010年12月全院共送检细菌培养标本123481份,共分离出38438株病原菌,分离率为31.1%,以革兰阴性菌为主。其中ICU共送检22332标本,分离出9761株病原菌,分离率为43.7%;ICU和普通病房各年度主要病原菌分布有较大差异(2008:χ2=27.147,P<0.05;2009:χ2=256.186,P<0.05;2010:χ2=274.049,P<0.05)。ICU多重耐药菌分离率耐甲氧西林金黄色葡萄球菌为64.68%(489/756)、产超广谱β-内酰胺酶细菌为55.45%(889/1603)、泛耐药鲍曼不动菌为78.88%(1128/1430)、泛耐药铜绿假单胞菌为50.00(327/654),明显高于普通病房[39.12%(885/2262)、42.20%(2519/5969)、43.47%(1059/2436)和35.26%(1020/2893)]。病原菌体外药敏结果显示:革兰阴性杆菌对氨苄西林、头孢噻肟、哌拉西林/他唑巴坦、环丙沙星、亚胺培南的敏感率2010年均较2008年有所降低,革兰阳性球菌对青霉素、红霉素、头孢唑林的耐药率>90%。结论 ICU病房病原菌的检出率高于普通病房,病原菌以条件致病菌和多重耐药菌为主,其耐药性不断增强。
Objective To investigate the distribution and drug resistance of pathogens isolated from intensive care unit（ICU） and general wards in our hospital to provide evidence for reasonable use of antibiotics and the prevention and control of nosocomial infection.Methods The type,distribution and drug susceptibility of pathogens isolated in our hospital from Jan.2008 to Dec.2010 were statistically analyzed.Results A total of 38438 pathogens were isolated from 123481 samples collected from Jan.2008 to Dec.2010.The isolating rate was 31.1%.And 9,761 pathogens were isolated from 22332 ICU samples,with isolating rate as 43.7%.Most of pathogens were gram-negative bacteria.The type and distribution in each year showed no difference.The multidrug resistant bacteria from ICU were more than those from general wards.The isolating rate of methicillin resistant staphylococcus aureus,extended-spectrum beta-lactamases,pan-drug resistant Acinetobacter baumanmii and pan-drug resistant Pseudomonas aeruginosa from ICU was 55.77%,57.32%,78.89% and 50.08% respectively,while that from general wards was 55.06%,52.17%,43.49% and 35.28% respectively.The results of drug susceptibility of isolated pathogens showed that the drug resistant rate of gram-negative bacilli to Ampicillin,Cefotaxime,Piperacillin/Tazobactam,Ciprofloxacin and Imipenem increased year by year,and the drug resistance rate of gram-positive cocci to Penicillin,Erythromycin and Cefazolin was more than 90%.Conclusions The isolating rate of pathogens from ICU is higher than that from general wards.Conditional and multi-drug resistant pathogens are the mainly isolated bacteria,and their drug resistance rates increase gradually.
出处
《实用医院临床杂志》
2011年第5期89-91,共3页
Practical Journal of Clinical Medicine
