【摘要】 为探讨医院ＩＣＵ内获得性感染的特点及其防治，作者对３５例ＩＣＵ内择期手术后患者进行微生物培养，２４例获阳性结果，计９７次１１７个菌株。ＩＣＵ患者的微生物标本最常见来源为痰，其次分别为引流物、血液、尿便及深静脉插管。培养出的７７株细菌共包含了１９种菌属，其中绿脓杆菌、阴沟肠杆菌、金黄色葡萄球菌以及大肠杆菌等４种即占６３％。对１６种抗生素的药敏检测提示，所有细菌均存在不同程度的耐药性。霉菌感染正日益成为ＩＣＵ内最危险的感染。全部２４例感染患者中，１２例合并霉菌感染，检出霉菌共４０株，占全部感染菌株的３４．２％；死亡６例，死亡率达５０％，远高于单纯细菌感染。作者指出：坚持ＩＣＵ内定期菌群监测，及时根据药敏调整抗生素，充分引流外科感染灶，重视深部霉菌感染的防治，改善ＩＣＵ的抗感染布局，是防治ＩＣＵ内获得性感染的重要手段。更多还原

【Abstract】 In 84 consecutive patients who were treated in ICU,35 had microbiological 5 data. 117 strains (bacteria:77;fungus:40) were isolated from 24 of the 35 patients for 97 times.The positive rate was 68.6%,or 28.6% of 84 patients.The gram negative bacilli were still the main source of nosocomial infection in ICU,especially the pseudomonas aeruginosa,clostridium welchii, and E. coli,but gram positive cocci,especially MRSA infection were also increased. Mycotic infection increased very rapidly.12 of the 24 patients were found a complicated mycotic infection. Six of the 12 (50%) died. Candida tropicalis and candida guilliermondi replaced candida albicans as the main pathogenic fungus.Sputum is still the most important specimen source of positive culture,followed by wound drainage,blood,urine,central venous catheter as well as feces.It is indicated that the respiratory system is still the main focus of nosocomial infection,and mycotic infection is most dangerous in ICU.Regular monitoring of microbial flora changes, detection correct use of antibiotics by drug sensitivity test,adequate surgical drainage,early and prevention of mycotic infection as well as improvement of ICU design will prevent or minimize the nosocomial infection in ICU.更多还原