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目的：了解神经外科重症监护病房（NICU）常见病原菌及其耐药情况，为临床抗菌药物合理使用提供理论依据。方法：收集 2009 年1 月-2010 年12 月NICU 收治患者的各种标本，对病原菌的分布情况及其对抗菌药物的耐药情况进行回顾性分析。结果：分离出病原菌537 株，其中革兰氏阴性菌239 株(占68.72 %)，革兰氏阳性菌139 株(占25.88 %)，真菌29 株(占5.40 %)；前5 位病原菌依次为鲍曼不动杆菌(19.93%)、肺炎克雷伯菌(18.44%)、金黄色葡萄球菌(12.29%)、铜绿假单胞菌(7.82%)、大肠埃希氏菌 (5.77%)；产超广谱β- 内酰胺酶(ESBLs)肺炎克雷伯菌和大肠埃希氏菌分离率分别为37.37 %、64.52%；耐甲氧西林金黄色葡萄球菌(MRSA)分离率和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)分离率分别为63.08%、87.50%。结论：NICU 病原菌以革兰氏阴性菌为主，对常用抗菌药物的耐药性高。需持续进行细菌流行病学及耐药性监测，指导临床合理使用抗菌药物，减少细菌耐药性产生。

英文摘要:

Objective: To investigate the pathogen and its drug resistance in neurosurgery intensive care unit(NICU) for providing the theoretical evidence in the appropriate administration of antimicrobials. Methods: Kinds of specimens of patients treated in NICU of our hospital from January 2009 to December 2010 were collected. The distribution status of pathogen and its antimicrobial resistance were retrospectively analyzed. Results: 537 pathogenic strains were separated, including 239 (68.72%) Gram-negative bacteria, 139 (25.88%) Gram-positive bacteria and 29 (5.40%) fungi. The top five detection rates of the pathogenic were acinetobacter baumannii (19.93%), klebsiella pneumoniae(18.44%), Staphylococcus aureus(12.29%), Pseudomonas aeruginosa(7.82%), Escherichia coli(5.77%). The isolation rates of ESBLs-producing klebsiella pneumoniae and Escherichia coli were 37.37% and 64.52%.The isolation rates of methicillin- resistant Staphylococcus aureus (MRSA) and Methicillin-resistant coagulase-negative staphylococci(MRCNS) were 63.08% and 87.50%. Conclusions: Gram-negative bacilli was the major pathogenic bacteria in NICU with high resistant rates to commonly used antibiotics. It is necessary to have continuing surveillance of Bacteria Epidemiology and drug resistant, and use antibacterials rationally to reduce bacterial resistance.

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