目的：探讨外科ICU严重腹腔感染患者的病原菌分布及耐药性，为临床经验用药提供参考依据。方法回顾性分析2012年1月～2013年12月58例严重腹腔感染患者的资料，对患者的病原学发布及耐药性进行分析。结果共分离出病原菌178株，其中革兰阴性杆菌126株，占70．79％，以大肠埃希菌为主；革兰阳性球菌39株，占20．79％，以屎肠球菌为主；真菌13株，占8．42％。大肠埃希菌和肺炎克雷伯菌产ESBLs菌株检出率分别为67．50％和57．25％，对碳青霉烯类抗菌药物耐药率低。初始病原菌分布以革兰阴性杆菌为主，第2、3周之后革兰阳性球菌分离率上升，真菌则多在第3周后出现。58例中混合病原菌感染占89．66％，细菌和真菌混合感染又占30．50％。未检出耐万古霉素肠球菌属。结论严重腹腔感染的病原菌以革兰阴性杆菌为主，混合感染的发生率及细菌的耐药率比较高，及早、合理的经验性抗感染治疗有利于控制细菌耐药的产生和播散。%Objective To investigate the distribution and antibiotic resistance of clinical pathogen isolated from patients of intra abdominal infection associated sepsis in surgical intensive care unit (SICU) of our hospital, then instruct clinical application of antibiotics reasonably. Methods The clinical data of sIAI patients in our ICU from January 2012 to December 2013 were retrospectively analyzed. All the specimens were analyzed for pathogen distribution and drug susceptibility. Results A total of 151 strains of pathogenic bacteria was isolated , in which Gram-negative bacteria were the most popular pathogen (126 strains, 70.79%), among which escherichia coli was dominant, whereas Gram-positive bacteria accounted for 20.79% (39 strains), among which enterococcus faecium was the predominant species; and fungi accounted for 8.42% (13 strains). Of the 58 patients with sIAS, the mixed infections accounted for 89.66%. The rate of the ESBL-producing strains of escherichia coli and pneumonia were 67.50% and 57.25%. Both of them showed low resistance to carbapenem antibiotics. Conclusion Gram-negative bacteria were the most popular pathogen of the sIAI patients. The mixed infections rates and the resistance of the pathogen isolated from the patients are seriously high. Early and rational using of antibiotics is of great importance to control the production and transmission of drug resistance.
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