2012年重症监护病房细菌耐药监测

摘要

Objective To investigate the antimicrobial resistance of main clinical isolates from ICU during 2012 .Methods Auto-matic microbiology analysis system and the disk diffusion method were performed to determine the antimicrobial susceptibility .All the data were analyzed by WHONET5 .6 software according to the breakpoints of The American Association of Clinical Laboratory Standardization Institute (CLSI) 2012 .Results A total of non-repeated 1 374 clinical isolates were collected in ICU during 2012 , including 1 089 strains (79 .3% ) of Gram-negative bacilli and 285 strains (20 .7% )of Gram-positive cocci ;The top five pathogens were Acinetobacter baumannii ,Pseudomonas aeruginosa ,Escherichia coli ,Klebsiella pneumoniae and Staphylococcus aureus ;Some Enterobacteriaceae strains were resistant to imipenem or ertapenem .2 strains of Enterococcus faecium were found resistant to van-comycin .Conclusion Non-fermenting bacteria ,Enterobacteriaceae and Staphylococci remain the predominant pathogens isolated from the patients in ICU ,their drug resistance is serious ,it is important to use antibacterial agents rationally and strengthen the sur-veillance of bacterial drug resistance .%目的：了解2012年重症监护室病房（IC U ）患者临床主要分离细菌的耐药性。方法：采用自动化仪器法和纸片扩散法测定抗菌药物敏感性，参照美国临床实验室标准化协会（CLSI）2012年版判定标准判读结果，用WHONET5．6软件统计分析。结果2012年共收集IC U病房非重复临床分离株1374株，其中革兰阴性菌1089株（79．3％），革兰阳性菌285株（20．7％）；分离率排在前5位的细菌依次为鲍曼不动杆菌、铜绿假单胞菌、大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌；肠杆菌科细菌对亚胺培南和厄它培南出现耐药株；检出2株万古霉素耐药的屎肠球菌。结论：该院IC U病房细菌来源以非发酵菌、肠杆菌科细菌、葡萄球菌属为主，耐药性比较严重，必须重视抗菌药物的合理使用，加强细菌耐药监测。