目的 分析血培养分离出的念珠菌的菌种分布及耐药分析,为临床念珠菌血症的诊治提供理论依据.方法 回顾性分析2017年1月-2020年12月期间,本院血培养分离出的念珠菌的菌种分布、药敏试验结果及患者血培养分离出念珠菌前后96h内的G试验结果.结果 血培养中分离出念珠菌314例,阳性率2.1％,其中非重复分离株212例.检出率最高的是近平滑念珠菌(72株,34.0％),其次是白念珠菌(55株,25.9％)和光滑念珠菌(28株,13.2％).念珠菌检出率最高的科室为ICU(62株,29.2％),其次是新生儿科(39株,18.4％)和血液科(20株,9.4％).检出的212株念珠菌除一株近平滑念珠菌为两性霉素B的非野生株,其余均为两性霉素B的野生株.白念珠菌对唑类药物的敏感率超过90％.但光滑念珠菌和热带念珠菌对唑类药物的敏感性较低.血培养分离出念珠菌的前后96h内,G试验的阳性率为73.7％.结论 本院念珠菌检出率前3位分别是近平滑念珠菌、白念珠菌和光滑念珠菌.光滑念珠菌、热带念珠菌对唑类药物敏感性比较低,在经验用药时需要合理选择抗真菌药物.G试验对念珠菌血症有较高的价值,需要对结果进行动态监测.

目的 回顾性分析2010-2014年中国侵袭性真菌耐药监测网(CHIF-NET) 62所监测中心重症监护室(ICU)侵袭性酵母的现状,了解我国侵袭性酵母分布的特征及其对唑类药物的耐药情况.方法 收集各所监测中心初步鉴定的菌株,送至北京协和医院检验科,采用基质辅助激光解吸电离飞行时间质谱技术结合分子测序技术对所有菌株进行复核鉴定,再进行唑类药物敏感性检测.结果 2010-2014年,62所监测中心ICU共检出侵袭性酵母2 863株,其中以念珠菌属最多,计2 771株.标本类型包括血液标本(50.8％,1 453/2863),无菌体液标本(49.2％,1 410/2863);其中,50.7％(1 404/2 771)的念珠菌属分离自血液标本.5年间,白念珠菌对氟康唑和伏立康唑十分敏感,敏感率＞99.0％;热带念珠菌对氟康唑和伏立康唑的耐药率显著升高,均从12.2％升至23.1％(P＜0.01);光滑念珠菌对氟康唑的耐药率也显著升高,从14.7％升至27.7％ (P＜0.01).非念珠菌属中,新型隐球菌复合体对伏立康唑全部敏感,从2013年开始出现对氟康唑耐药菌;其他酵母对两种唑类药物耐药率整体较高,分别为43.6％和32.7％.菌株复核鉴定的正确率为86.2％(2 467/2 863).结论 ICU中侵袭性酵母分离株中以念珠菌属为主,主要分离自血液,氟康唑和伏立康唑对其抗菌作用非常显著;而非白念珠菌的耐药率有不同程度的升高及交叉耐药的出现,临床需要加以重视.

BACKGROUND:To evaluate in vitro susceptibilities of aerobic and facultative Gram-negative bacterial (GNB) isolates from intra-abdominal infections (IAIs) to 12 selected antimicrobials in Chinese hospitals from 2012 to 2014.METHODS:Hospital acquired (HA) and community acquired (CA) IAIs were collected from 21 centers in 16 Chinese cities. Extended spectrum beta-lactamase (ESBL) status and antimicrobial susceptibilities were determined at a central laboratory using CLSI broth microdilution and interpretive standards.RESULTS:From all isolated strains the Enterobacteriaceae (81.1%) Escherichia coli accounted for 45.4% and Klebsiella pneumoniae for 20.1%, followed by Enterobacter cloacae (5.2%), Proteus mirabilis (2.1%), Citrobacter freundii (1.8%), Enterobacter aerogenes (1.8%), Klebsiella oxytoca (1.4%), Morganella morganii (1.2%), Serratia marcescens (0.7%), Citrobacter koseri (0.3%), Proteus vulgaris (0.3%) and others (1.0%). Non- Enterobacteriaceae (18.9%) included Pseudomonas aeruginosa (9.8%), Acinetobacter baumannii (6.7%), Stenotrophomonas maltophilia (0.9%), Aeromonas hydrophila (0.4%) and others (1.1%). ESBL-screen positive Escherichia coli isolates (ESBL+) showed a decreasing trend from 67.5% in 2012 to 58.9% in 2014 of all Escherichia coli isolates and the percentage of ESBL+ Klebsiella pneumoniae isolates also decreased from 2012 through 2014 (40.4% to 26.6%), which was due to reduced percentages of ESBL+ isolates in HA IAIs for both bacteria. The overall susceptibilities of all 5160 IAI isolates were 87.53% to amikacin (AMK), 78.12% to piperacillin-tazobactam (TZP) 81.41% to imipenem (IMP) and 73.12% to ertapenem (ETP). The susceptibility of ESBL-screen positive Escherichia coli strains was 96.77%-98.8% to IPM, 91.26%-93.16% to ETP, 89.48%-92.75% to AMK and 84.86%-89.34% to TZP, while ESBL-screen positive Klebsiella pneumoniae strains were 70.56%-80.15% susceptible to ETP, 80.0%-87.5% to IPM, 83.82%-87.06% to AMK and 63.53%-68.38% to TZP within the three year study. Susceptibilities to all cephalosporins and fluoroquinolones were less than 50% beside 66.5% and 56.07% to cefoxitin (FOX) for ESBL+ Escherichia coli and Klebsiella pneumoniae strains respectively.CONCLUSIONS:The total ESBL+ rates decreased in Escherichia coli and Klebsiella pneumoniae IAI isolates due to fewer prevalence in HA infections. IPM, ETP and AMK were the most effective antimicrobials against ESBL+ Escherichia coli and Klebsiella pneumoniae IAI isolates in 2012-2014 and a change of fluoroquinolone regimens for Chinese IAIs is recommended.

目的 检测我国引起隐球菌病的新型隐球菌对6种常用抗真菌药物敏感性,并建立其流行病学折点.方法 选取中国医院侵袭性真菌耐药监测网(CHIF-NET) 10家监测中心2009年8月-2012年7月临床分离的新型-戈特隐球菌复合体,统一采用显色微量肉汤稀释法在各自监测中心检测菌株对临床常用的6种抗真菌药物的最低抑菌浓度(MIC)值.结果 我国临床分离的隐球菌属绝大部分为新型隐球菌格鲁比变种,181株新型-戈特隐球菌复合体中,仅有2株为戈特隐球菌;179株新型隐球菌,格鲁比变种占98.9％;新型隐球菌中有122株分离自脑脊液占68.2％,40株分离自血液占22.3％;新型隐球菌格鲁比变种的流行病学折点分别为氟康唑16mg/L、伏立康唑0.12 mg/L、泊沙康唑0.25 mg/L、伊曲康唑0.25 mg/L、氟胞嘧啶16 mg/L、两性霉素B1 mg/L.结论 该项研究建立的流行病学折点将有利于对获得性耐药菌株的检出、临床药敏报告的解读以及今后临床折点的建立.

Background: Recently, the emergence of multidrug-resistant organisms such as extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriaceae has raised considerable concern regarding the appropriate treatment of intra-abdominal infections (Yds). In this study, we investigated the molecular characteristics of ESBL among clinical isolates of Escherichia coli and Klebsiella pneumoniae causing lAls and their pattern of antimicrobial resistance, which can provide useful information about the epidemiology and risk factors associated with these infections. Materials and methods: One hundred sixty-seven E.co li and 47 K. pneumoniae ESBL-producing strains causing IAIs were collected from 9 hospitals in China, during 2012 and 2013. The antimicrobial susceptibility profile of these strains was determined. Polymerase chain reaction and sequencing were performed to identify genes for beta-lactamase (bIaTEM, b1aSHV, blaOXA-1-like, and blaCTX-M). The isolates were also analyzed by pulsed-field gel electrophoresis (PFGE). Results: In 167 ESBL-producing E. coli strains, 104 strains (623%) were positive for CTX-M, and 9 strains (5.39%) were positive for SHV. Among the 47 K. pneumoniae strains, 35 strains (74.5%) were positive for SHV-2a, 12 strains (25.5%) were positive for CTX-M. No TEM-type and OXA-1-like strain was detected among all the ESBL-producing strains. Regarding the CTX-M-positive E. coli and K. pneumoniae strains, CFX-M-15 was the most common genotype in E. coli and K. pneumoniae strains, accounting for 28.7% and 17.0%, respectively, followed by CTX-M-55 accounting for 16.2% and 2.13%, respectively; the remaining genotypes included CTX-M-123 and CTX-M-82. PFGE showed that E.coli and K. pneumoniae ESBL-producing strains causing lAls were diverse and that emerging resistance may not be due to the dissemination of national clones. Conclusion: The present study revealed that in ESBL-producing strains causing IAIs in China, the most common genotype for E.coli was CTX-M-15 and for K. pneumoniae was SHV-2a. However, there was a wide diversity of strains causing 'Ms among the ESBL-producing E. coll. and K. pneumoniae. (C) 2016 Elsevier Inc. All rights reserved.

ABSTRACT To evaluate the antimicrobial susceptibility of Gram-negative bacilli that caused hospital-acquired and community-acquired intra-abdominal infections (IAIs) in China between 2012 and 2013, we determined the susceptibilities to 12 antimicrobials and the extended-spectrum β-lactamase (ESBL) statuses of 3,540 IAI isolates from seven geographic areas in China in a central laboratory using CLSI broth microdilution and interpretive standards. Most infections were caused by Escherichia coli (46.3%) and Klebsiella pneumoniae (19.7%). Rates of ESBL-producing E. coli ( P = 0.031), K. pneumoniae ( P = 0.017), and Proteus mirabilis ( P = 0.004) were higher in hospital-acquired IAIs than in community-acquired IAIs. Susceptibilities of enterobacteriaceae to ertapenem, amikacin, piperacillin-tazobactam, and imipenem were 71.3% to 100%, 81.3% to 100%, 64.7% to 100%, and 83.1% to 100%, respectively, but imipenem was ineffective against P. mirabilis (<20%). Although most ESBL-positive hospital-acquired isolates were resistant to third- and fourth-generation cephalosporins, the majority were susceptible to cefoxitin (47.9% to 83.9%). Susceptibilities of ESBL-positive isolates to ampicillin-sulbactam (<10%) were low, whereas susceptibilities to ciprofloxacin (0% to 54.6%) and levofloxacin (0% to 63.6%) varied substantially. The prevalences of cephalosporin-susceptible E. coli and K. pneumoniae were higher in the northeastern and southern regions than in the central and eastern regions, reflecting the ESBL-positive rates in these areas, and were lowest in the Jiangsu-Zhejiang (Jiang-Zhe) area where the rates of carbapenem resistance were also highest. Ertapenem, amikacin, piperacillin-tazobactam, and imipenem are the most efficacious antibiotics for treating IAIs in China, especially those caused by E. coli or K. pneumoniae . Resistance to cephalosporins and carbapenems is more common in the Jiang-Zhe area than in other regions in China.

OBJECTIVE To evaluate the results of original identification ,Vitek MS and Bruker MS identification of Candida glabrata species complex collected from National China Hospital Invasive Fungal Surveillance Net (CHIF‐NET) in 2010‐2014 .METHODS A total of one C .bracarensis isolate and twelve C .nivariensis isolates were collected from the CHIF‐NET in 2010‐2014 ,and 411 C .glabrata isolates were collected from eleven hospi‐tals which participated in the CHIF‐NET in five consecutive years from 2010 to 2014 .All of the strains were iden‐tified by using molecular method ,the review identification results were set as"gold‐standard",the results of origi‐nal identification of the conventional methods were evaluated ,and the performances of Vitek MS and Bruker MS matrix assisted laser desorption ionization time of flight mass spectrometry (MALDI‐TOF MS) in the identifica‐tion of the C .glabrata species complex were observed .RESULTS As compared with the molecular identification , the accurate rate of original identification of C .glabrata was 90 .3% ,and 9 .7% of the strains were mistakenly i‐dentified as Candida parapsilosis and Candida albicans by CHROMagar chromogenic media ,ID 32C ,API 20C or Vitek 2 Compact system .C .nivariensise and C .bracarensis could not be identified by using routine identification methods .The accurate rates of the Vitek MS and Bruker MS were 97 .6% and 100 .0% ,respectively .There were no reference spectra for C .bracarensis and C .nivariensis in the Vitek MS 2 .0 database ,so the two species could not be identified .There were reference spectra for the two species in the Bruker Biotyper 3 .1 database ,however , one C .bracarensis isolate could not be identified and all of the 12 C .nivariensise isolates were identified correctly , with the spectral score varying from 1 .708 to 1 .944 .CONCLUSION It is for the first time to evaluate the perform‐ances of Vitek MS and Bruker MS in identification of the C .glabrata species complex in China and is concluded that the two methods are reliable for the identification of the C .glabrata .Bruker MS is superior to Vitek MS in identification of the rare species of Candida .

Staphylococcus aureus is the leading cause of many human infectious diseases. Besides infectious dangers, S. aureus is well-known for the quickly developed drug resistance. Although great efforts have been made, mechanisms underlying the antibiotic effects of S. aureus are still not well clarified. Recently, reports have shown that oxidative stress connects with bactericidal antibiotics [Dwyer et al. (2009) Curr. Opin. Microbiol. 12: , 482-489]. Based on this point, we demonstrate that reactive oxygen species (ROS) induced by sublethal vancomycin may be partly responsible for the antibiotic resistance in heterogeneous vancomycin resistant S. aureus (hVRSA). Sublethal vancomycin treatment may induce protective ROS productions in hVRSA, whereas reduction in ROS level in hVRSA strains may increase their vancomycin susceptibility. Moreover, low dose of ROS in VSSA (vancomycin susceptible S. aureus) strains may promote their survival under vancomycin conditions. Our findings reveal that modest ROS generation may be protective for vancomycin resistance in hVRSA. These results recover novel insights into the relationship between oxidative stress and bacterial resistance, which has important applications for further use of antibiotics and development of therapeutics strategies for hVRSA.

The elimination of viral covalently closed circular DNA (cccDNA) from the nucleus of infected hepatocytes is an obstacle to achieving sustained viral clearance during antiviral therapy of chronic hepatitis B virus (HBV) infection. The aim of our study was to determine whether treatment with siRNA is able to suppress viral cccDNA amplification using a HBV-transgenic mice model. The experimental results revealed that siRNAs can serve as efficient alternative anti-HBV agents, because they showed better inhibitory effect on viral replication and antigen expression in transgenic mice. More importantly, the siRNA markedly inhibited HBV cccDNA amplification.

Common pathogen composition and drug resistance of blood culture samples in the first affiliated hospital of Harbin Medical University from 2008 to 2012 was investigated. Pathogens of blood culture were identified. MIC test and Kirby-Bauer disc diffusion test were used to detect the antimicrobial sensitivity. WHONET 5. 6 statistic software was applied for analyzing the bacterial spectrum and drug resistance. A total of 4 245 strains of pathogens were isolated. Coagulase-negative Staphylococcus was the most,947 strains acounted for 22. 3%,E. coli was the second,822strains,followed by Klebsiella pneumoniae,520 strains,Acinetobacter baumannii,195 strains,and Staphylococcus aureus,142 strains. The detection rates of the MRCNS and MRSA of S. aureus were 81. 1% and 38. 8% respectively.MRCNS vancomycin,linezolid and teicoplanin resistant Staphylococcus and S. aureus were not found. The positive rates of ESBLs-producing E. coli and K. pneumoniae were 55. 2% and 53. 8% respectively. The drug resistance rates to cefoperazone /sulbactam,piperacillin /tazobactam,cefotetan,cefoxitin,and amikacin were fairly low. There was also resistance in carbapenem antibiotics. The resistance rate of A. baumannii was generally high against antibiotics.Therefore,it is important to carry out monitor and inspect pathogenic bacteria in blood culture timely and accurately,in order to direct the rational use of antibiotics and to control the emergence of drug resistant strains.

OBJECTIVES To define the antifungal susceptibility patterns of the most common non-albicans Candida spp. in China. METHODS We evaluated the susceptibilities to nine antifungal drugs of Candida parapsilosis species complex, Candida tropicalis, Candida glabrata species complex and Candida krusei isolates from patients with invasive candidiasis at 11 hospitals over 3 years. Isolates were identified by MALDI-TOF MS supplemented by DNA sequencing. MICs were determined by Sensititre YeastOne(TM) using current clinical breakpoints/epidemiological cut-off values to assign susceptibility (or WT), and by CLSI M44-A2 disc diffusion for fluconazole and voriconazole. RESULTS Of 1072 isolates, 392 (36.6%) were C. parapsilosis species complex. C. tropicalis, C. glabrata species complex and C. krusei comprised 35.4%, 24.3% and 3.7% of the isolates, respectively. Over 99.3% of the isolates were of WT phenotype to amphotericin B and 5-flucytosine. Susceptibility/WT rates to azoles among C. parapsilosis species complex were ≥97.5%. However, 11.6% and 9.5% of C. tropicalis isolates were non-susceptible to fluconazole and voriconazole, respectively (7.1% were resistant to both). Approximately 14.3% of C. glabrata sensu stricto isolates (n = 258) were fluconazole resistant, and 11.6% of C. glabrata sensu stricto isolates were cross-resistant to fluconazole and voriconazole. All C. krusei isolates were susceptible/WT to voriconazole, posaconazole and itraconazole. Overall, 97.7%-100% of isolates were susceptible to caspofungin, micafungin and anidulafungin, but 2.3% of C. glabrata were non-susceptible to anidulafungin. There was no azole/echinocandin co-resistance. Disc diffusion and Sensititre YeastOne(TM) methods showed >95% categorical agreement for fluconazole and voriconazole. CONCLUSIONS In summary, reduced azole susceptibility was seen among C. tropicalis. Resistance to echinocandins was uncommon.

目的 了解碳青霉烯类耐药肺炎克雷伯菌及耐药机制.方法 对2012-2013年临床分离的耐碳青霉烯类肺炎克雷伯菌共计12株进行分析,药敏采用MIC方法检测,用WHONET 5.6软件进行分析,KPC表型检测采用改良Hodge试验,基因检测采用PCR方法.结果 12株碳青霉烯类耐药肺炎克雷伯菌改良Hodge试验阴性,基因测序为KPC-2型.结论 KPC-2基因是引起本院肺炎克雷伯菌耐药的主要原因.

观察联合应用siRNA对HepG2.2.15细胞中HBV抗原表达和复制的抑制作用。应用ELISA方法检测HBeAg和HBsAg;HBV DNA水平用实时定量PCR测定;用RT-PCR检测HBV mRNA水平。结果显示,实验中应用的HBV特异性siRNA均具有明显的抗HBV抗原表达和病毒复制作用;联合应用siRNA较单独应用具有更强的抗HBV作用。可见,HepG2.2.15细胞中联合应用siRNA对HBV复制的抑制作用比单独应用siRNA更有效。

Objective To investigate the distribution and antimicrobial resistance of Enterobacter cloacae in ICU and provide theroretical basis of rational usage of antibiotics for the clinic. Methods A total of 141 strains of Enterobacter cloacae were collected in ICU from 2009 to 2012. Identification and antimicrobial susceptibility test of isolates were performed using a Vitek-2 Compact automtic system. Results The most strains were isolated from blood( 38. 3%),then sputum( 26. 2%) and urine( 17. 0%). Antimicrobial susceptibility test showed that the resistant rates to ampicillin and cefazolin were the highest,over 85%. The rates to the third generation cephalosporins were 50% ~ 70%,the rates to aminoglycoside and fluoroquinolone antibiotics were below 60%,and the rates to cefepime and carbapenems were below 30%. Conclusion The antimicrobial resistance of Enterobacter cloacae is serious in ICU. Cefepime and carbapenems are susceptible to it and can be used to treat infections caused by Enterobacter cloacae.

OBJECTIVE To understand the distribution of bacterial species in the ICU between 2009 and 2011and analyze the drug resistance so as to guide the reasonable use of antibiotics.METHODS Totally 2510 cases of patients with pathogens cultured positive,who were hospitalized the ICU from Jan 2009 to Dec 2011,were enrolled in the study,then the identification of the bacterial isolates and the drug susceptibility testing were performed by using the VITEK-2Compact full automatic bacterial identification instrument or API system,and the constituent ratio of the pathogenic bacteria and the result of drug susceptibility testing were analyzed.RESULTS A total of 2510 strains of pathogens were isolated,including 1553(61.87%)strains of gram-negative bacilli,434(17.29%)strains of gram-positive cocci,and 523(20.84%)strains of fungi;the Acinetobacter baumannii,Staphylococcus aureus,Klebsiella pneumonia,and Candida albicans ranked the top four species of pathogens,accounting for16.73%,12.31%,10.60%,and 10.60%,respectively.There were 1487(59.2%)strains isolated from the sputum and 246(9.8%)strains isolated from the blood specimens.The gram-positive cocci were highly resistant to the commonly used antibiotics and were sensitive to chloromycetin,and no strains resistant to linezolid,vancomycin,or teicoplanin were found;the main gram-negative bacilli were highly resistant to the commonly used antibiotics except that the Escherichia coli was 100.0% sensitive to meropenem and piperacillin-tazobactam.CONCLUSIONThe gram-negative bacteria are the predominant pathogens causing the infections in ICU during the past three years,the drug resistance rate shows an upward trend,the A.baumannii is highly resistant;the cases with fungal infections are increased.It is of great significance to dynamically monitor the distribution of pathogens in ICU and the change of drug resistance.

OBJECTIVE To study the characteristics of AmpC-enzyme and extended-spectrumβ-lactamases produced by multidrug-resistant Enterobacter cloacae in ICU so as to provide theoretical basis for reasonable clinical use of antibiotics.METHODS The three dimensional testing was performed to detect the AmpC-enzyme and ESBLs.Genes were extracted and amplified by PCR,the PCR products were sequenced and confirmed,and the homology of the tested strains was analyzed through PFGE method.RESULTS Of totally 24 strains of multidrugresistant E.cloacaetested through three dimensional testing,15 isolates of AmpC enzyme-producing strains and 13 isolates of ESBLs-producing strains have been detected,among which there were 6 strains simultaneously producing AmpC enzyme and ESBLs.There were 16 strains producing AmpC enzyme mediated by chromosome,the ampC and ampD were the predominant encoding genes;there were 7 strains producing AmpC enzyme mediated by plasmid,and DHA-1 was the main encoding gene.There were 12(50.0%)strains producing ESBLs with SHV-12 as the predominant encoding gene.Of totally 24 isolates of tested strains,3 strains were identified as the same clone.CONCLUSION The production of AmpC-enzyme and ESBLs is an important mechanism of multidrug-resistance of E.cloacae.It is necessary for the clinicians to reasonably use antibiotics based on result of drug susceptibility testing so as to avoid the emergence and spread of multidrug-resistant strains.

调查鲍曼不动杆菌的临床分布及其对抗菌药物的耐药情况,为临床合理用药提供依据。将哈尔滨医科大学第一附属医院临床各种来源的鲍曼不动杆菌1582株采用K-B法进行药敏试验,并对结果进行统计分析。2008至2010年共检出鲍曼不动杆菌1582株,临床分布以ICU最多（484株,占54.5%）。对抗菌药物的耐药率逐年增高,ICU抗菌药物的耐药率明显高于非ICU病区。该菌株对临床常用抗菌药物高度耐药和多重耐药,对亚胺培南和美罗培南耐药率高达90.9%和90.3%。鲍曼不动杆菌耐药情况相对严重,临床须重视鲍曼不动杆菌的感染,加强院內感染的控制及耐药性的监测,根据药敏结果选择合适抗生素,延缓耐药性进程。

了解哈尔滨医科大学附属第一医院重症监护病房( ICU)病原菌的分布特点及耐药性,为临床治疗提供理论依据.对2003年1月至2010年12月ICU患者送检的标本进行培养,用API鉴定系统或VITEK 2 Compact全自动细菌鉴定仪进行菌种鉴定及药敏分析,对检出菌株的构成、标本的分布及药敏结果进行分析.共分离出4 197株病原菌,其中革兰阴性杆菌52.1％、革兰阳性球菌22.3％、真菌25.6％；革兰阴性杆菌中非发酵菌占主要地位(37.5％),以鲍曼不动杆菌为主(13.1％)；而肠杆菌科细菌则以肺炎克雷伯菌(9.5％)及大肠埃希菌(5.1％)为主；革兰阳性球菌以金黄色葡萄球菌(14.6％)为主,真菌以白假丝酵母菌(11.8％)为主；在检出所有病原菌的标本中,前3位依次为痰液(79.1％)、血液(8.4％)、无菌体液(8.1％)；细菌耐药性结果表明,大肠埃希菌及肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)阳性率分别为66.4％、56.3％.几种主要病原菌对各类抗菌药物的耐药程度各不相同,但大部分菌株均呈现多重耐药的现象.产酶菌的耐药率普遍高于非产酶菌,哌拉西林/他唑巴坦对产酶菌及非产酶菌的抑菌效果都很明显；美罗培南、亚胺培南和头孢替坦对肠杆菌科细菌耐药率最低均在40％以下,可作为产酶菌的首选药；鲍曼不动杆菌耐药性严重耐药率均在50％以上.耐甲氧西林葡萄球菌(MRS)检出率为70.1％,其中耐甲氧西林金黄色葡萄球菌(MRSA) 75.8％,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS) 38.7％.万古霉素、替考拉宁和利奈唑烷可作为革兰阳性球菌严重感染的首选药物.ICU患者以呼吸道感染为主,病原菌以鲍曼不动杆菌和金黄色葡萄球菌为主,且多为多重耐药菌.真菌感染率增加且真菌对药物的敏感性好.应动态监测ICU病原菌的流行和耐药情况,从而控制医院内感染,减少耐药菌株的产生.