摘要
目的观察综合性重症监护病房(ICU)医院感染的种类、感染菌株的流行、变迁的特点及耐药性的变化。方法10年监测的结果分成A、B、C各阶段总结,比较不同时期的变化。结果分离出革兰阴性杆菌987株(76.4%),革兰阳性球菌216株(16.7%),真菌89株(6.9%);排前6名菌株依次是铜绿假单胞菌、鲍氏不动杆菌、金黄色葡萄球菌、肺炎克雷伯菌、大肠埃希菌、嗜麦芽寡养单胞菌;感染部位:肺部感染92.3%,尿路感染5.2%,其他(胸、腹、脑脊液、血液等)感染2.5%。结论ICU医院感染以革兰阴性杆菌为主(75%),革兰阳性球菌感染稍有上升,真菌感染有所下降;绝大多数革兰阴性杆菌、产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希菌对碳青酶烯类抗菌药物保持了较高的敏感性;所有革兰阳性球菌对万古霉素、替考拉宁保持了良好的敏感性;真菌感染中,白色假丝酵母菌的感染比例下降,非白色假丝酵母菌的感染比例上升。
OBJECTIVE To observe the type of nosocomial infections in our comprehensive ICU, the prevalence and the vicissitude characteristic of infection strains, and the change of antibiotic-resistance. METHODS To summarize the 10 year results of the monitoring which were divided into three stages to compare the changes with time. RESULTS Gram-negative bacilli were 987 （76.4%）, Gram-positive cocci 216 （16. 7%） strains, and 89 strains were fungi （6.9 % ）. The top six strains were in turn.. Pseudomonas aeruginosa , Acinetobacter baurnannii, Staphylococcus aureus, Klebsiella pneumoniae, Escherichia coli, and Stenotrophomonas rnaltophilia. Distribution of infection sites： 92. 3% infection was in lungs, 5. 2% in urinary tract infection, 2. 5% in other sites included lungs, abdomene, CSF, blood etc. CONCLUSIONS The main nosocomial infective pathogens in our ICU are Gramnegative bacilli （75. 0%）, Gram-positive bacterial infection shows a slight increasing, whereas fungi infection decreasing. In addition to S. maltophilia, the great majority of Gram-negative bacilli, ESBL-producing K. pneurnoniae and E. coli maintain a higher sensitivity to carbapenem antibiotic. All Gram-positive cocci to vancomycin and teicoplanin maintain a good sensitivity. In the fungal infection, Candida albicans infection ratio is decreased, while non-C. albicans increases.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2008年第12期1754-1757,共4页
Chinese Journal of Nosocomiology
关键词
下呼吸道感染
重症监护病房
病原菌
流行病学
耐药性
Lower respiratory tract infection
ICU
Pathogens
Epidemiology
Antibiotic-resistance
