目的 分析2016-2018年河南科技大附屬醫(yī)院胸外科重癥監(jiān)護(hù)室感染性疾病病原菌的分布及耐藥性。方法 回顧性分析2016-2018年河南科技大附屬醫(yī)院胸外科重癥監(jiān)護(hù)室病原菌的分布和耐藥性。結(jié)果 2016-2018年送檢樣本主要來(lái)自于痰液和尿液，且隨著年限的增加，樣本數(shù)逐漸增加。共檢測(cè)樣本36 298份，致病菌共檢測(cè)出2 484株，檢出率為6.84%。臨床分離病原菌中分離率最高的為大腸埃希菌、銅綠假單胞菌、肺炎克雷伯菌、鮑曼不動(dòng)桿菌和金黃色葡萄球菌。其中大腸埃希菌在2017年的分離率最高，為41.32%。2016-2018年主要病原菌的耐藥率從總體來(lái)看，呈不斷上升的趨勢(shì)，其中大腸埃希菌、肺炎克雷伯菌和銅綠假單胞菌對(duì)呋喃妥因和頭孢唑啉的耐藥率較高。2016-2018年大腸埃希菌、肺炎克雷伯菌和銅綠假單胞菌對(duì)呋喃妥因和頭孢唑啉的耐藥率均為100.00%，對(duì)厄他培南的耐藥率較低，均為0.00%。肺炎克雷伯菌和銅綠假單胞菌對(duì)哌拉西林的耐藥率上升最為明顯，在2017年耐藥率達(dá)到100.00%。金黃色葡萄球菌對(duì)氨芐西林、頭孢唑啉、阿莫西林/克拉維酸、哌拉西林的耐藥率較高，對(duì)阿米卡星、頭孢他唑啶、厄他培南的耐藥率較低；凝固酶陰性葡萄球菌對(duì)氨芐西林、環(huán)丙沙星、頭孢唑啉、哌拉西林、氨曲南的耐藥率較高，對(duì)阿米卡星、亞胺培南、左旋氧氟沙星、厄他培南的耐藥率較低。結(jié)論 2016-2018年河南科技大附屬醫(yī)院感染病原菌的檢出率逐年升高，病原菌的耐藥性也有逐年上升的趨勢(shì)，應(yīng)引起感染科及其他相關(guān)部門(mén)的重視，嚴(yán)格控制抗生素的使用。

Objective To explore the distribution and drug resistance of infectious diseases in intensive care unit of Department of Thoracic Surgery of Henan University of Science and Technology from 2016 to 2018. Methods A retrospective survey was conducted to analyze the distribution and drug resistance of pathogenic bacteria in the intensive care unit of Department of Thoracic Surgery of Henan University of Science and Technology from 2016 to 2018. Results The samples submitted from 2016 to 2018 mainly came from sputum and urine, and the number of samples increased gradually with the increase of years. A total of 36 298 samples and 2 484 strains of pathogenic bacteria were detected, and the detection rate was 6.84%. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus had the highest isolation rate among clinical isolates. E. coli had the highest separation rate in 2017 with 41.32%. The resistance rate of major pathogens from 2016 to 2018 was on a rising trend. Among them, E. coli, K. pneumonia, and P. aeruginosa had high resistance rate to nitrofurantoin and cefazolin. The resistance rates of E. coli, K. pneumonia, and P. aeruginosa to nitrofurantoin and cefazolin were 100.00% from 2016 to2018, and the resistance rate to ertapenem was low, both were 0. The resistance rate of K. pneumoniae and P. aeruginosa to piperacillin increased the most obvious, and the resistance rate reached 100.00% in 2017. S. aureus had higher resistance to ampicillin, cefazolin, amoxicillin/clavulanic acid, and piperacillin, and lower resistance to amikacin, ceftazidime, and ertapenem. Coagulase-negative staphylococci were highly resistant to ampicillin, ciprofloxacin, cefazolin, piperacillin, and aztreonam, and were resistant less to amikacin, imipenem, levofloxacin, and ertapenem. Conclusion The detection rate of nosocomial pathogens in Henan Science and Technology Affiliated Hospital increased gradually from 2016 to 2018, and the drug resistance of pathogenic bacteria also increased year by year. It should cause the attention of infectious diseases and other related departments, and strictly to control the use of antibiotics.

R978.1