目的 探究北京豐臺(tái)醫(yī)院ICU患者感染病原菌的分布及耐藥性情況，以指導(dǎo)抗菌藥物的使用。方法 收集2014-2016年北京豐臺(tái)醫(yī)院ICU患者的各類標(biāo)本，對(duì)ICU患者感染病原菌的分布及耐藥性情況進(jìn)行統(tǒng)計(jì)分析。結(jié)果 共分離出4 311株病原菌，其中革蘭陰性菌2 161株，占50.1%，以大腸埃希菌、鮑曼不動(dòng)桿菌、銅綠假單胞菌為主；革蘭陽(yáng)性菌1 548株，占35.9%，以金黃色葡萄球菌、肺炎鏈球菌和溶血葡萄球菌為主；真菌602株，占14.0%，以白假絲酵母、熱帶假絲酵母、光滑假絲酵母為主。大腸埃希菌和銅綠假單胞菌對(duì)多黏菌素E、亞胺培南、阿米卡星、美羅培南、哌拉西林和頭孢哌酮等頭孢菌素和青霉素類藥物都保持較高敏感性。而鮑曼不動(dòng)桿菌耐藥性較強(qiáng)，僅對(duì)多黏菌素E保持較高敏感性；主要革蘭陽(yáng)性菌均對(duì)萬(wàn)古霉素和替考拉寧有較好的敏感性，而對(duì)青霉素和紅霉素等藥物耐藥性較強(qiáng)；主要真菌對(duì)氟康唑、5-氟胞嘧啶、兩性霉素B、伏力康唑、伊曲康唑均有較好敏感性。結(jié)論 北京豐臺(tái)醫(yī)院ICU患者感染病原菌以革蘭陰性菌為主，合理應(yīng)用抗菌藥物是延緩病原菌耐藥性、控制醫(yī)源性感染的重要方法。

Objective To explore the distribution and drug resistance of pathogenic bacteria in ICU of Beijing Fengtai Hospital, in order to guide the use of antimicrobial agents. Methods The samples of ICU patients in Beijing Fengtai Hospital from 2014 to 2016 were collected, and the distribution and drug resistance of pathogenic bacteria of ICU patients were analyzed retrospectively. Results Total 4 311 strains of pathogens were isolated, in which Gram-negative bacteria were 2 161 strains (50.1%), and main of them were Escherichia coli, Acinetobacter baumannii, and Pseudomonas aeruginosa. Gram-positive bacteria (1 548 strains) accounted for 35.9%, and main of them were Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus haemolyticus. Fungi were 602 strains (14.0%), and main of them were Candida albicans, C. tropicalis, and C. glabrata. E. coli and P. aeruginosa were highly sensitive to cephalosporins and penicillins such as polymyxin E, imipenem, amikacin, meropenem, piperacillin, and cefoperazone. While the resistance of A. baumannii was strong, and only maintain a high sensitivity to polymyxin E. Main Gram-positive bacteria were sensitive to vancomycin and teicoplanin, while the drug resistance against penicillin and erythromycin were strong. Main fungi were sensitive to fluconazole, 5-fluorocytosine, amphotericin B, viconazole, and itraconazole. Conclusion The main pathogens in ICU of Beijing Fengtai Hospital is still Gram-negative bacteria. The rational application of clinical antimicrobial drugs is an important method to delay the drug resistance of pathogens and to control iatrogenic infection.