神经外科重症监护病房常见病原菌及耐药性分析

目的:了解神经外科重症监护病房(NICU)常见病原菌及其耐药情况,为临床抗菌药物合理使用提供理论依据。方法:收集2009年1月-2010年12月NICU收治患者的各种标本,对病原菌的分布情况及其对抗菌药物的耐药情况进行回顾性分析。结果:分离出病原菌537株,其中革兰氏阴性菌239株(占68.72%),革兰氏阳性菌139株(占25.88%),真菌29株(占5.40%);前5位病原菌依次为鲍曼不动杆菌(19.93%)、肺炎克雷伯菌(18.44%)、金黄色葡萄球菌(12.29%)、铜绿假单胞菌(7.82%)、大肠埃希氏菌(5.77%);产超广谱β-内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希氏菌分离率分别为37.37%、64.52%;耐甲氧西林金黄色葡萄球菌(MRSA)分离率和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分离率分别为63.08%、87.50%。结论:NICU病原菌以革兰氏阴性菌为主,对常用抗菌药物的耐药性高。需持续进行细菌流行病学及耐药性监测,指导临床合理使用抗菌药物,减少细菌耐药性产生。

Analysis of Commonly Pathogens and its Drug Resistance in NICU

Objective: To investigate the pathogen and its drug resistance in neurosurgery intensive care unit(NICU) for providing the theoretical evidence in the appropriate administration of antimicrobials.Methods: Kinds of specimens of patients treated in NICU of our hospital from January 2009 to December 2010 were collected.The distribution status of pathogen and its antimicrobial resistance were retrospectively analyzed.Results: 537 pathogenic strains were separated,including 239(68.72%) Gram-negative bacteria,139(25.88%) Gram-positive bacteria and 29(5.40%) fungi.The top five detection rates of the pathogenic were acinetobacter baumannii(19.93%),klebsiella pneumoniae(18.44%),Staphylococcus aureus(12.29%),Pseudomonas aeruginosa(7.82%),Escherichia coli(5.77%).The isolation rates of ESBLs-producing klebsiella pneumoniae and Escherichia coli were 37.37% and 64.52%.The isolation rates of me-thicillin-resistant Staphylococcus aureus(MRSA) and Methicillin-resistant coagulase-negative staphylococci(MRCNS) were 63.08% and 87.50%.Conclusions: Gram-negative bacilli was the major pathogenic bacteria in NICU with high resistant rates to commonly used an-tibiotics.It is necessary to have continuing surveillance of Bacteria Epidemiology and drug resistant,and use antibacterials rationally to reduce bacterial resistance.