343例ICU病原菌分布与耐药性分析
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Analysis of pathogen distribution and resistance in ICU
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    目的:了解南京医科大学第一附属医院2007年 ICU病原菌分布及细菌耐药情况,为临床防治提供依据-方法:采用API鉴定系统鉴定细菌及真菌;纸片扩散法测定细菌药物敏感性,Rosco纸片法测定真菌药物敏感性;WHONET 5.4软件进行统计分析-结果:2007年该院总标本数为4 431份,ICU标本数为343份,阳性率为7.7%,病原菌以G-为主,占70.7%,其中非发酵菌占46.9%,肠杆菌科细菌占23.8%-非发酵菌以铜绿假单胞菌(37.3%)和不动杆菌(7.6%)多见,肠杆菌科细菌以克雷伯菌(10.5%)-大肠埃希菌(6.1%)为多;G+菌以金黄色葡萄球菌(金葡菌)为主-从耐药性分析来看,葡萄球菌属未发现万古霉素耐药株,但对其他多种抗菌药物耐药;肠杆菌科细菌对亚胺培南-美洛培南-头孢哌酮/舒巴坦和阿米卡星较敏感;非发酵菌中,铜绿假单胞菌对大部分抗菌药物耐药,而不动杆菌则对美洛培南-亚胺培南和头孢哌酮/舒巴坦较敏感-结论:该院ICU感染病原菌对多种抗菌药物耐药率较高,应合理选择抗菌药物-

    Abstract:

    Objective:To analyze the pathogen distribution and resistance in ICU of our hospital so as to provide the evidence for treatment. Methods:The bacteria and fungi were identified by API system; the sensitivity of antimicrobial agents and antifungal agents was tested by K-B and Rosco disk diffusion method; the data was analyzed by WHONET 5.4. Results:In 2007,there were 3341 specimens in our hospital including 343 specimens in ICU, and the positive rate of specimens was 7.7%. Gram-negative bacteria(70.7%) was the mains in ICU. Among the total, the rate of Nonfermenters was 46.9% and Enterobacteriaceae was 23.8%. Most of Nonfermenters were P. aeruginosa(37.3%) and Acinetobacter(7.6%). The majority of Gram-positive bacteria were Staphylococcus aureus. In view of the resistance, Staphylococcus species resistant to Vancomycin, while they were resistant to many other antimicrobial agents. Gram-negative Enterobacteriaceae were fairly sensitive to carbapenems, cefoperazone/sulbactam and piperacillin/tazobactam. Among nonfermenters, P. aeruginosa were resistant to the most antimicrobial agents while Acinetobacter were comparatively sensitive to carbapenems and cefoperazone/sulbactam. Conclusion:The pathogens in ICU have a high resistant rate to many antimicrobial agents. In view of the seriousness of this problem, we must lay enough emphasis on it and select antimicrobial agents rational.

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居 峰,顾 兵,盛 敏.343例ICU病原菌分布与耐药性分析[J].南京医科大学学报(自然科学版),2009,29(2):267-271

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  • 收稿日期:2008-10-11
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