目的了解某院重症监护室（ICU）患者体内多重耐药菌的定植情况和耐药特点。方法应用细菌学监测的方法对2008年11月—2009年4月入住该院ICU的82例患者鼻前庭拭子和直肠拭子进行筛查培养，并做药敏试验。采用WHONET5.4软件进行数据分析。结果在38例患者标本中检测到多重耐药菌，定植率为46.34%。包括62株产超广谱β内酰胺酶（ESBLs）肠杆菌科细菌和4株耐甲氧西林金黄色葡萄球菌（MRSA），未检测到多重耐药的鲍曼不动杆菌和铜绿假单胞菌。62株产ESBLs肠杆菌科细菌对亚胺培南、美罗培南耐药率 (4.84%) 低，对其他抗菌药物耐药率较高，不同细菌耐药情况不尽相同；4株MRSA除对万古霉素、替考拉宁、利奈唑胺完全敏感，对克林霉素、磷霉素和庆大霉素部分敏感外，对其他抗菌药物均耐药。结论该院 ICU患者体内多重耐药菌定植率高，耐药现象严重，应引起临床医生的高度重视，加强监测，避免多重耐药菌在医院暴发流行。
Objective To understand the colonization and resistance characteristics of multidrugresistant bacteria isolated from ICU patients. Methods Nasal vestibular and rectal swabs of 82 patients admitted in a hospital ICU from November, 2008 to April, 2009 were screened by bacteriological surveillance method, and antimicrobial susceptibility were performed. Data were analyzed by WHONET5.4 software. Results Multidrugresistant strains were detected among 38 patients , the colonization rate was 46.34%, which including 62 strains of extendedspectrum β lactamases (ESBLs) producing Enterobacteriaceae bacteria and 4 strains of methicillinresistant Staphylococcus aureus(MRSA), and multidrugresistant Acinetobacter baumannii and Pseudomonas aeruginosa was not detected. 62 strains of ESBLsproducing strains had lower drugresistant rates (4.84%) to imipenem and meropenem,but had high sensitive rates to the other antimicrobial agents, resistant rates varied with different bacteria; 4 MRSA strains were all sensitive to vancomycin, teicoplanin and linezolid, some were sensitive to clindamycin, fosfomycin and gentamicin, and all were resistant to other antimicrobials.Conclusion Colonization rate of multidrugresistant bacteria is high in patients in ICU, and drugresistance is serious, which should be paid attention by clinicians , surveillance should be intensified , so as to avoid the outbreak of multidrugresistant bacteria infection in hospital.
陈振华,刘文恩,邹明祥,吴安华,艾宇航. ICU多重耐药菌定植调查及耐药性分析  FREE[J].中国感染控制杂志,2010,9(3):155-159复制