摘要
目的监控外科重症加强治疗病房(SICU)中医院获得性感染的病原菌耐药性,指导临床防治。方法监测分析我院SICU 2001年1月至2004年12月间医院获得性感染的情况。结果平均感染率为11．3％,常见感染部位是呼吸道(30．9％)、腹腔(29．0％)、血液(9．7％)和胆道(7．2％);常见病原菌是铜绿假单胞菌(11．6％)、凝固酶阴性葡萄球菌(11．1％)、白色念珠菌(9．7％)。大肠埃希菌和肺炎克雷伯菌中超广谱β内酰胺酶(ESBLs)产生株的检出率分别为66．2％和58．5％;耐甲氧西林的金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)检出率分别是94．7％和88．2％。碳青霉烯类对肠杆菌的抗菌活性最强,非发酵菌耐药严重;万古霉素、替考拉宁对革兰阳性球菌活性最强,二性霉素B对真菌抗菌活性最强。结论SICU医院获得性感染耐药问题严重,不同感染部位的病原菌各有特点,建立感染监控机制,掌握医院获得性感染的耐药性变化是有效预防和治疗的关键。
Objective To investigate the drug resistance of pathogenic bacteria of nosocomial infections in the surgical intensive care unit. Methods The drug resistance of pathogenic bacteria of nosocomial infections in the SICU in our hospital from January 2001 to December 2004 were analyzed. Results The average nosocomial infections rate was 11.3%. The major sites of nosocomial infections were respiratory tract （30. 9% ）, abdominal cavity （29. 0% ）, bloodstream （9.7%） and biliary ducts（7.2% ）. The most common pathogens were pseudomonas aeruginosa （ 11.6% ）, methicillin-resistant coagulase negative staphylococci （ 11.1% ） and candida albieans （9. 7% ）. ESBLs-producing strains accounted for 66. 2% and 58.5% of eseheriehia eoli and klebsiella spp. respectively. Methicillin-resistant staphylococcus aureus accounted for 94.7% and methicillin-resistant coagulase negative staphylococci accounted for 88.2% in staphylococcus aureus and eoagulase negative staphylococci. Carbapenems were the most powerful antibiotics against enterobacteriaceae. The non-fermenters were high resistant to antimicrobial agents. Vancomycin was the most potent antimicrobial against gram positive cocci. Amphotericin B was the most active antibiotic against fungi. Conclusions Most strains of pathogens were antibiotic resistant in SICU. The main pathogenic bacteria of each infection site were different. So it is essential to establish nosocomial infections surveillance system in order to prevent, control and treat nosocomial infections effectively.
出处
《中华外科杂志》
CAS
CSCD
北大核心
2006年第17期1189-1192,共4页
Chinese Journal of Surgery
关键词
病原菌
抗药性
院内感染
外科重症加强治疗病房
Pathogenic bacteria
Drug resistance
Nosocomial infections
Surgical intensive care unit
