ICU与非ICU感染患者病原菌分布及耐药性对比分析
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李艺

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R969.3

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Distribution and drug resistance of pathogens isolated from patients in intensive care units and nonintensive care units
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    摘要:

    目的分析重症监护室(ICU)与非ICU患者感染病原菌的分布和耐药情况,为临床抗感染治疗提供依据。方法对2006年5月—2007年5月临床各科室送检标本进行细菌分离培养与鉴定,并对ICU与非ICU患者感染病原菌分布及耐药性进行对比分析。结果从ICU患者标本中分离培养出病原菌150株,其中非发酵菌总构成比为40.67%(61/150);非ICU患者标本分离培养出病原菌495株,非发酵菌总构成比为17.98%(89/495)。ICU患者非发酵菌检出率高于非ICU患者(χ2 =33.20,P<0.01)。ICU患者分离的主要病原菌依次为真菌(21.33%)、铜绿假单胞菌(17.33%)、大肠埃希菌(12.67%);非ICU患者分离的主要病原菌依次为真菌(20.61%)、大肠埃希菌(17.98%)、金黄色葡萄球菌(10.30%)。ICU患者感染的鲍曼不动杆菌和金黄色葡萄球菌耐药较严重;第三代头孢菌素在治疗革兰阴性杆菌感染时,ICU与非ICU患者耐药差异较大。结论ICU患者非发酵菌检出率高,其感染的病原菌耐药严重,应加强管理与监测。

    Abstract:

    ObjectiveTo analyze the distribution and drug  resistance of pathogens isolated from patients in intensive care units( ICUs) and  nonICUs, so as to provide evidence for clinical antiinfective treatment. MethodsBacterial  strains from patients in clinical departments from May 2006 to May 2007 were isolated and identified,  pathogenic distribution and antimicrobial resistance  between ICUs and nonICUs were compared and analyzed.ResultsOne hundred and fifty strains were isolated from patients in ICUs, the constitutional ratio of nonfermentative bacteria was 40.67%(61/150); 495 strains were isolated from nonICUs, the constitutional ratio of nonfermentative bacteria  was 17.98%(89/495). The isolation rate of nonfermentative bacteria from ICUs was higher than that of nonICUs (χ2=33.20,P<0.01). The most common pathogens in ICUs were fungi(21.33%),Pseudomonas aeruginosa(17.33%) and Escherichia coli(12.67%); The most common pathogens in nonICU were fungi (20.61%),Escherichia coli (17.98%) and Staphylococcus aureus (10.30%). Antimicrobial resistance of Acinetobacter baumannii and Staphylococcus aureus isolated from ICUs were serious;  The resistance to the third generation cephalosporins for treating infection with gramnegative bacilli was quite different between ICUs and nonICUs.ConclusionThe isolation rate of nonfermentative bacteria in ICUs is high, and drug resistance is serious, which should be given strengthened management and surveillance.

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李艺,吴江萍,董玉梅,等. ICU与非ICU感染患者病原菌分布及耐药性对比分析[J]. 中国感染控制杂志,2008,7(6):405-408.
LI Yi, WU Jiangping, DONG Yumei, et al. Distribution and drug resistance of pathogens isolated from patients in intensive care units and nonintensive care units[J]. Chin J Infect Control, 2008,7(6):405-408.

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  • 收稿日期:2008-02-25
  • 最后修改日期:2008-05-09
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  • 在线发布日期: 2008-11-30
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