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目的 了解神经外科加强医疗病房 ( NSICU )获得性细菌感染的病原菌及耐药情况。方法 回顾性调查天坛医院 NSICU1995～ 1998年 4月所有细菌分离株及耐药情况。结果 革兰阳性 ( G+ )球菌比例从 1995年 3 0 %升至 1997年 4 0 % ,其中耐苯唑青霉素金黄色葡萄球菌 ( MRSA )和耐苯唑青霉素表皮葡萄球菌 ( MRSE)占葡萄球菌的 81%。G- 杆菌中 ,不动杆菌、铜绿假单胞菌 ,肠杆菌属分别占 3 6%、3 3 %、11%。伊米配能、阿米卡星、头孢他啶、环丙沙星对革兰阴性 ( G- )杆菌的耐药率分别为 2 2 %、4 1%、4 6%、4 6%。万古霉素对 MRSA、MRSE及肠球菌的耐药率分别是 0 %、0 %、4 0 %。结论 NSICU的莸得性细菌感染以肺部感染为主 ,G+ 球菌已成为重要致病菌 ;建立常规流行病学监测制度对指导经验性选择抗生素是必要的 ;其他综合性治疗措施也应给予足够重视。
Objective To understand the pathogenic bacteria and drug resistance of neurosurgical patients with acquired bacterial infections in medical ward (NSICU). Methods Retrospectively surveyed all bacterial isolates and drug resistance in NSICU1995 ~ April 1998 in Tiantan Hospital. Results The proportion of Gram-positive (G +) cocci increased from 30% in 1995 to 40% in 1997, among which, resistance to oxacillin-resistant Staphylococcus aureus (MRSA) and oxacillin-resistant Staphylococcus epidermidis (MRSE) 81%. Acinetobacter, Pseudomonas aeruginosa and Enterobacter were 36%, 33% and 11% respectively in G-bacteria. The resistance rates of imipenem, amikacin, ceftazidime and ciprofloxacin to gram-negative bacilli were 22%, 41%, 46% and 46% respectively. The rates of vancomycin resistance to MRSA, MRSE and enterococci were 0%, 0% and 40% respectively. Conclusions Sick bacteria infection in NSICU is mainly pulmonary infection, and G + coccus has become an important pathogenic bacteria. Establishing a routine epidemiological monitoring system is necessary to guide the empirical selection of antibiotics. Other comprehensive treatment measures should be given enough Pay attention.