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目的 分析重症监护病房 (ICU)呼吸道感染的流行病学及细菌耐药情况 ,为临床防治提供依据。方法 对重症监护病房 1998年 12月～ 2 0 0 0年 12月由呼吸道分泌物所分离的细菌菌株及细菌耐药性进行回顾性调查 ,结果加以整理分析。结果 革兰阴性杆菌占 6 7.3 % ,仍以铜绿假单胞菌为主 (5 3 .2 % ) ,金黄色葡萄球菌中 ,耐甲氧西林金黄色葡萄球菌 (MRSA)占 2 9.7% ,表皮葡萄球菌有上升趋势 ,在细菌耐药性方面 ,革兰阴性杆菌对头孢吡肟、泰能、舒普深耐药率最低。MRSA对万古霉素仍敏感 ,无一例耐药。结论 ICU获得性感染中仍以革兰阴性杆菌为主 ,革兰阳性球菌也在增加 ,应受到重视。重症监护病房抗菌药物耐药的出现使治疗某些感染变得非常困难 ,危及生命 ,及时掌握病原菌及耐药性的最新动态 ,指导临床医生正确选用抗生素 ,意义重大。
Objective To analyze the epidemiology and bacterial resistance of respiratory tract infection in intensive care unit (ICU) and provide basis for clinical prevention and treatment. Methods The bacterial strains isolated from respiratory secretions from December 1998 to December 2010 in the intensive care unit and their drug resistance were retrospectively reviewed and the results were analyzed. Results Gram-negative bacilli accounted for 6 7.3%, mainly Pseudomonas aeruginosa (53.2%), Staphylococcus aureus, methicillin-resistant Staphylococcus aureus (MRSA) accounted for 2 9.7% Staphylococcus aureus is on the rise. In terms of bacterial resistance, Gram-negative bacilli have the lowest rate of resistance to cefepime, tacrolimus and shuopunshen. MRSA vancomycin is still sensitive, no case of drug resistance. Conclusions Gram-negative bacilli are still the main cause of ICU-acquired infections, and gram-positive cocci are also increasing. The emergence of antimicrobial resistance in ICU makes it very difficult to treat some infections, endanger lives, keep abreast of the latest developments in pathogens and drug resistance, and guide clinicians in the proper selection of antibiotics.