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目的探讨我院呼吸科重症监护病房(RICU)患者发生医院感染的主要病原菌的分布及耐药性,为临床合理用药提供依据。方法回顾性分析在我院RICU住院治疗的发生医院感染的186例患者的病原菌构成比、分布特点及药敏试验等情况。结果共分离出483株病原菌,其中革兰阴性菌占74.53%,依次为铜绿假单胞菌、鲍曼不动杆、大肠埃希菌、嗜麦芽寡养单胞菌等;革兰阳性球菌占16.15%,以金黄色葡萄球菌为主;真菌占9.32%,以白色念珠菌为主。感染部位依次为肺部感染(52.07%)、尿路感染(21.20%)、导尿管相关感染(15.21%)。铜绿假单胞菌、鲍曼不动杆菌和大肠埃希菌对阿米卡星的耐药率较低,但鲍曼不动杆菌耐药情况严重。结论肺部感染是RICU患者医院感染的主要感染类型,革兰阴性杆菌是主要病原菌,且鲍曼不动杆菌呈多重耐药。
Objective To investigate the distribution and drug resistance of major pathogens causing nosocomial infection in respiratory intensive care unit (RICU) patients in our hospital and provide the basis for clinical rational drug use. Methods A retrospective analysis of hospitalized patients with RICU in our hospital 186 cases of nosocomial infection pathogens composition, distribution characteristics and susceptibility testing and so on. Results A total of 483 strains of pathogens were isolated, of which Gram-negative bacteria accounted for 74.53%, followed by Pseudomonas aeruginosa, Bowman’s pole, Escherichia coli, Stenotrophomonas maltophilia, etc.; 16.15%, mainly Staphylococcus aureus; fungi accounted for 9.32%, mainly Candida albicans. Infection was followed by pulmonary infection (52.07%), urinary tract infection (21.20%) and catheter-related infection (15.21%). Pseudomonas aeruginosa, Acinetobacter baumannii and Escherichia coli amikacin resistance rate is low, but Acinetobacter baumannii drug resistance is serious. Conclusions Pulmonary infection is the main type of nosocomial infection in patients with RICU. Gram-negative bacilli are the main pathogens, and Acinetobacter baumannii is multi-drug resistant.