摘要
目的探讨综合性ICU病原菌分布特点及变化趋势,为ICU有效地预防与控制医院感染提供依据。方法统计分析2007-2010年医院ICU送检的1237份标本分离的病原菌分布,不同年份病原菌的构成比较用SPSS10.0进行卡方检验。结果共分离出病原菌722株,其中革兰阴性菌386株占53.46%,革兰阳性菌159株占22.02%,真菌177株占24.52%;送检尿、便以真菌为主,分泌物以革兰阳性菌为主,病原菌中占首位的是白色假丝酵母菌占13.85%,其次为铜绿假单胞菌、耐甲氧西林金黄色葡萄球菌、鲍氏不动杆菌、肺炎克雷伯菌,分别占12.33%、11.91%、8.73%、6.37%;铜绿假单胞菌2008年最高18.67%逐年减少至2010年6.41%;鲍氏不动杆菌2007年未检出,至2009年最高占14.55%,2010年减少至9.41%;耐甲氧西林金黄色葡萄球菌和耐甲氧西林表皮葡萄球菌在2007-2009年逐年下降,于2010年又呈现升高,差异有统计学意义(P<0.05)。结论 ICU感染的病原菌以革兰阴性菌为主,其次为真菌和革兰阳性菌,不同年份病原菌的种类、构成有所不同,在病原菌构成中革兰阴性菌呈下降趋势,真菌呈上升趋势,且有高度耐药菌集中的趋势。
OBJECTIVE To investigate the distribution and the changing trend of the pathogens in a comprehensive ICU so as to provide the reference for clinical prevention and control of nosocomial infections in ICU.METHODS From 2007 to 2010,the pathogens isolated from 1237 clinical specimens submitted from ICU were statistically analyzed.RESULTS A total of 722 strains of pathogens were isolated,including 386（53.46%） strains of gram-negative bacilli,159（22.02%） strains of gram-positive bacteria,and 177（24.52%） strains of fungi;the fungi were mainly isolated from the urine and stool,accounting for 13.85%,the gram-positive bacteria were mainly isolated from the secretions,accounting for 12.33%.Of all the pathogens isolated,Candida albicans ranked the first place（13.85%）,followed by Pseudomonas aeruginosa（12.33%）,methicillin-resistant Staphylococcus aureus（11.91%）,Acinetobacter baumannii（8.73%）,and Klebsiella pneumoniae（6.37%）.The isolation rate of P.aeruginosa was highest in 2008（18.67%）,then decreasing to 6.41% in 2010;the isolation rate of A.baumannii was 0% in 2007,increasing to the top（14.55%） in 2009,and decreasing to 9.41% in 2010.The isolation rates of methicillin-resistant S.aureus and S.epidermidis decreased year by year from 2007 to 2009,then increasing in 2010,the differences were statistically significant（P0.05）.CONCLUSION The gram-negative bacteria are the main pathogens causing infections in ICU,followed by the fungi and gram-positive bacteria.The species and distribution of the pathogens vary in different in years.Of all the pathogens isolated,the gram-negative bacteria present a downward trend,fungi upward tendency,tending to be high drug resistance.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2013年第3期686-688,共3页
Chinese Journal of Nosocomiology
