Objective To explore the gram-negative bacteria distribution and drug resistance in severe infections patients in ICU in our hospital.Methods Gram-negative bacteria in 260 cases of the clinical specimens from ICU department in our hospital from Mar 2012 to Mar 2013 were isolated and cultured,and the distribution and drug resistance in main gram-negative bacteria were analyzed.Results 300 cases of gram-negative bacteria were isolated from the 260 cases of specimens,and 203 cases were isolated from sputum,accounting for 67.7％.The mainly gram-negative bacteria in 300 cases were as follows:Pseudomonas aeruginosa (53 cases),Acinetobacter baumannii (45 cases),Klebsiella pneumonia (39 cases),Escherichia coli (33 cases) and Enterobacter cloacae (29 cases).The resistance rates of Pseudomonas aeruginosa to ampicillin/sulbactam and ceftriaxone were 73.6 ％ and 66.0％,Acinetobacter baumannii to ampicillin/sulbactam and piperacillin/tazobactam were 80％ and 68.9％,Klebsiella pneumoniae to ampicillin/sulbactam and ciprofloxacin were 53.8％ and 48.7％,Escherichia coli to levofloxacin and ampicillin/sulbactam were 78.8％ and 75.8％,Enterobacter cloacae to ampicillin/sulbactam and ceftriaxone were 82.8％ and 65.5 ％,respectively.Conclusions Drug resistance in gram-negative bacteria in ICU infection is more severe,and more attention should be paid to sterilization in ICU ward and rational use of antibiotics in order to minimize the risk of infection.%目的 探讨我院重症加强监护病房(ICU)重症感染患者革兰氏阴性菌的分布和耐药情况. 方法 对2012年3月至2013年3月我院ICU科室送检的260例标本进行革兰氏阴性菌分离培养,对细菌的分布以及主要革兰氏阴性菌的耐药性进行分析. 结果 260例标本中共分离出革兰氏阴性菌300株,其中痰液中分离203株(67.7％);300株革兰氏阴性菌中排名前5位的分别为铜绿假单胞菌53株,鲍曼不动杆菌45株,肺炎克雷伯菌39株,大肠埃希菌33株和阴沟肠杆菌29株;铜绿假单胞菌对氨苄西林/舒巴坦和头孢曲松的耐药率分别为73.6％和66.0％;鲍曼不动杆菌对氨苄西林/舒巴坦和哌拉西林/他唑巴坦的耐药率分别为80.0％和68.9％;肺炎克雷伯菌对氨苄西林/舒巴坦和环丙沙星的耐药率分别为53.8％和48.7％;大肠埃希菌对左氧氟沙星和氨苄西林/舒巴坦的耐药率分别为78.8％和75.8％;阴沟肠杆菌对氨苄西林/舒巴坦和头孢曲松的耐药率分别为82.8％和65.5％. 结论 ICU重症感染患者革兰氏阴性菌的耐药性较严重,应重视ICU的消毒杀菌,合理使用抗生素,尽量降低感染风险.
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