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目的 了解综合性 ICU获得性感染的流行病学及细菌耐药性情况 ,为临床防治提供依据。方法 对我院ICU 1996年 4月~ 1998年 4月所有分离的细菌菌株、真菌菌株及细菌耐药性进行回顾性调查。结果 医院获得性感染中仍以 G- 菌为主 4 9.1% ,其次为真菌 3 5 .8%、G+ 菌 15 .1%。在细菌感染中 ,G- 菌占 76.6% ,G+ 菌占 2 3 .4 %。 G- 菌仍以铜绿假单胞菌为主 ,占 3 2 .9%。 G+ 菌以金黄色葡萄球菌 (金葡菌 )为主 69.2 %。金葡菌中耐苯唑青霉素的金葡菌 ( MRSA )占 83 % ,表皮葡萄球菌中耐苯唑青霉素的表皮葡萄球菌 ( MRSE)占 66.7%。真菌以白色念珠菌为主 5 4 .8%。与 1996年 4月~ 1997年 4月所分离菌株相比 ,1997年 4月~ 1998年 4月 G+ 菌由 8.6%增加到 17.5 % ( P<0 .0 1) ,真菌由 2 3 .4 %增加到 4 0 .4 % ( P<0 .0 1) ,而 G- 菌由 68%降低到 4 2 .1% ( P<0 .0 1)。在细菌耐药性方面 ,G- 菌对泰能的耐药率最低为 2 9.4 %。结论 虽 ICU获得性感染中仍以 G- 菌为主 ,但 G+ 菌及真菌已逐渐成为重要致病菌 ,应受到重视 ;获得性感染菌谱的变迁及细菌耐药率升高 ,使临床经验性选择抗生素治疗获得性感染更加困难。
Objective To understand the epidemiology and bacterial drug resistance of comprehensive ICU-acquired infections and provide evidence for clinical control. Methods A retrospective survey was conducted on all isolated bacterial strains, fungal strains, and bacterial resistance of the ICU from April 1996 to April 1998. Results Hospital-acquired infections still accounted for 41.1% of G-bacteria, followed by 35.8% for fungi and 15.1% for G+ bacteria. In bacterial infections, G-bacteria accounted for 76.6% and G+ bacteria accounted for 23.4%. G-bacteria were still dominated by Pseudomonas aeruginosa, accounting for 32.9%. G+ bacteria accounted for 69.2% of Staphylococcus aureus (S. aureus). In S. aureus, oxacillin-resistant Staphylococcus aureus (MRSA) accounted for 83%, and Staphylococcus epidermidis resistant to oxacillin-resistant Staphylococcus epidermidis (MRSE) accounted for 66.7%. The fungi were mainly Candida albicans 54.8%. Compared with isolates from April 1996 to April 1997, G+ bacteria increased from 8.6% to 17.5% (P<0.01) from April 1997 to April 1998, and fungi accounted for 23.4%. Increased to 40.4% (P<0.01), while G-bacteria decreased from 68% to 42.1% (P < 0.01). In terms of bacterial resistance, the resistance rate of G-bacteria to Thaineng was a minimum of 29.4%. Conclusion Although G-bacteria are still predominant in ICU-acquired infections, G+ bacteria and fungi have gradually become important pathogens and should be taken seriously; changes in the spectrum of acquired infections and the increase in bacterial resistance rate make clinical experience Sexual selection of antibiotics to treat acquired infections is more difficult.