急诊重症监护病房医院感染病原菌分布及耐药性分析
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Pathogenic bacteria distribution and drug resistance of hospital infection in emergency intensive care unit
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    目的:分析南京医科大学第一附属医院急诊重症监护病房(emergency intensive care unit,EICU) 医院感染病原菌分布及其耐药现状,为临床合理用药和控制医院感染提供依据。方法:对2006年1月~2007年6月该院EICU 医院感染患者的各类标本中分离出的病原菌,采用K-B 纸片扩散法进行敏感试验,对致病菌耐药率进行分析。结果:EICU医院感染病原菌多为耐药菌,病原菌以革兰阴性杆菌(G-)为主占65.33%、革兰阳性球菌(G+)第二占18.29%、真菌第三占16.38%;革兰阴性杆菌中以铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌及大肠埃希菌为主;革兰阳性菌主要以葡萄球菌属为主;真菌以白假丝酵母、光滑假丝酵母菌为主。大肠埃希菌和肺炎克雷伯菌的产超广谱耐β-内酰胺酶(ESBLs)菌检出率分别为58.06%和30.00%;耐甲氧西林葡萄球菌(MRS)检出率为71.87%。结论:加强对EICU病原菌分布及耐药率监测,同时依据细菌病原学及抗菌药物敏感性结果,选择抗菌药物,以减少新的耐药株的出现,降低医院感染率。

    Abstract:

    Objective:To analyze the status of pathogenic bacteria distribution and drug resistance of hospital infection in emergency intensive care unit(EICU),for providing the guidance of clinical rational administration and decreasing the hospital infection. Methods:Pathogenic bacteria were isolated from the patients who suffered from hospital infection in EICU from January of 2006 to June of 2007. K-B slip diffusion method was taken to carry out the sensitive test . Rate of drug resistance of the pathogenic bacteria was analyzed. Results:The results showed that rate of the drug fast is very high. As the bacteria distribution ,the main pathogenic bacteria was the gram-negative bacilli(G-)(65.33 %), the second pathogenic bacteria was the gram-positive cocci(G+)(18.29%). and the mycetes(16.38%) occupied the third. In gram-negative bacilli the most were Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae and Escherichia coli;Staph is the main pathogenic bacteria in gram-positive cocci;and in mycetes the main pathogenic bacteria were Candida albicans and Candida glabrate. The detection rate of the extended spectrum β-lactamases(ESBLs) from the Escherichia coli and the Klebsiella pneumoniae was 58.06 % and 30.00%. The detection rate of the meticillin-resistant staphylococci(MRS) was 71.87%. Conclusion:Enhance monitoring on pathogenic bacteria distribution and drug resistance analyses of hospital infection in EICU could benefit for the guide of clinical rational administration,depressing multidrug-resistant bacteria and decreasing hospital infection.

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陈旭锋,黄培培,张劲松.急诊重症监护病房医院感染病原菌分布及耐药性分析[J].南京医科大学学报(自然科学版),2008,28(4):518-521

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  • 收稿日期:2007-09-25
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