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目的观察我院急诊重症监护病房(EICU)病原菌构成及耐药性变化,为临床合理使用抗菌药物提供理论依据。方法回顾性分析2010-2014年我院EICU住院患者病原菌分布及耐药性变化。结果 2010-2014年我院ICU送检合格标本中共分离出病原菌2 339株,其中革兰阳性菌626株、革兰阴性菌1 522株、真菌191株。2010-2014年革兰阳性菌分别占22.18%、27.30%、25.00%、28.39%和28.06%,革兰阴性菌分别占73.59%、67.84%、68.20%、62.45%和60.52%,真菌分别占4.23%、4.86%、6.80%、9.16%和11.42%。EICU常见致病菌主要为鲍曼不动杆菌、肺炎克雷伯杆菌、铜绿假单胞菌和凝固酶阴性葡萄球菌。同时鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯杆菌对临床常用抗菌药物的耐药率总体均呈逐渐上升趋势。结论 EICU感染病原菌菌种较多,加强病原菌动态监测,合理使用抗菌药物已成为当务之急。
Objective To observe the changes of pathogens and drug resistance of emergency ICU in our hospital and provide a theoretical basis for rational use of antimicrobial agents in clinic. Methods The distribution of pathogenic bacteria and drug resistance in hospitalized patients with EICU in our hospital from 2010 to 2014 were retrospectively analyzed. Results A total of 2 339 pathogens were isolated from the ICU samples in our hospital from 2010 to 2014, including 626 Gram-positive bacteria, 1 522 Gram-negative bacteria and 191 strains of fungi. Gram-negative bacteria accounted for 22.18%, 27.30%, 25.00%, 28.39% and 28.06% respectively in 2010-2014, while Gram-negative bacteria accounted for 73.59%, 67.84%, 68.20%, 62.45% and 60.52% %, 4.86%, 6.80%, 9.16% and 11.42%. Common pathogens of EICU are Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and coagulase-negative staphylococcus. At the same time, Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae showed a gradual upward trend toward resistance to common antibacterials. Conclusion There are many strains of pathogens in EICU infection and the dynamic monitoring of pathogens is strengthened. The rational use of antimicrobial agents has become a top priority.