目的 探讨广州市公职人员中眼睑黄色瘤（XP）患病情况与生化检验指标异常的相关性。方法 从2018年来广州市干部和人才健康管理中心体检的公职人员中选取1 090例，其中筛选患XP人员545例，作为病例组，依性别、年龄分层随机抽取的未患XP的人员作为对照组，测定空腹血糖、血脂、甲状腺功能等生化指标，采用回顾性病例对照研究的方式，比较两组相关指标水平。P＜0.05为差异有统计学意义。结果 XP的患病率为0.94%（男性为0.89%，女性为1.01%）。男性和女性的XP患病率比较差异无统计学意义（χ²=2.142，P=0.143）。两组间体质量、舒张压、血脂等多项指标上的差异具有统计学意义（P＜0.05）。高体质量（OR=1.021，95%CI：1.004~1.038，P=0.017）、高舒张压（OR=1.019，95%CI：1.004~1.035，P=0.011）、低高密度脂蛋白（OR=6.127，95%CI：2.568~14.619，P＜0.001）、高低密度脂蛋白（OR=2.084，95%CI：1.456~2.981，P＜0.001）是患病的危险因素。结论 广州市公职人员中XP的患病率男性和女性接近；高体质量、高舒张压、高密度脂蛋白水平降低、低密度脂蛋白水平升高是患XP的危险因素。

   Objective To investigate the correlation between xanthelasma palpebrarum（XP）and abnormal biochemical indices in healthy individuals in Guangzhou，China．Methods A retrospective case-control study was conducted，selecting 1 090 individuals from a total of 58 053 who underwent health examinations at the Guangzhou Cadre and Talent Health Management Centre in 2018．The case group consisted of 545 individuals diagnosed with XP，while the control group included age- and sex-matched individuals without XP，randomly selected from the same database．Biochemical indices analyzed included fasting blood glucose，blood lipids，liver and kidney function，thyroid indicators，body weight，and blood pressure．Statistical significance was set at P＜0.05．Results The prevalence of XP was 0.94%（0.89% in men and 1.01% in women）．No significant difference was observed in the prevalence of XP between men and women（χ²=2.142，P=0.143）．Similarly，no significant differences were observed in thyroid-stimulating hormone（P=0.937），free triiodothyronine（P=0.216），free thyroxin（P=0.206），or fasting blood glucose levels（P=0.668）between the case and control groups．However，significant differences were noted in body weight，diastolic blood pressure，blood lipid levels，and liver and renal biochemical indicators between the two groups（P＜0.05）．Specifically，higher body weight（OR=1.021，95%CI：1.004–1.038，P=0.017），higher diastolic blood pressure（OR=1.019，95%CI：1.004–1.035，P=0.011），lower high-density lipoprotein（OR=6.127，95%CI：2.568–14.619，P＜0.001），and higher low-density lipoprotein（OR=2.084，95%CI：1.456–2.981，P＜0.001）were identified as risk factors for XP．Conclusions The prevalence of XP did not differ between males and females．However，high body weight，high diastolic blood pressure，low high-density lipoprotein，and high low-density lipoprotein are risk factors for XP．

目的 分析医院职业暴露工作人员特征、发生职业暴露环节、类型及处理方式,为医院制订干预措施提供理论基础。方法 回顾性分析玉溪市人民医院2018—2023年共301例发生职业暴露工作人员资料, 包括职业暴露时间、性别、年龄、科室、岗位类型、在院工作时间、职位、职业暴露发生环节、职业暴露类型、暴露源、职业暴露后是否需要用药等处置信息。结果 301例职业暴露工作人员平均年龄为（28.81±10.92）岁, 女性占比84.7%（255例）; 57.8%（174例）职业暴露发生在检查/穿刺/注射/采血/置管/治疗/手术等操作中, 38.9%（117例）发生在医疗废物处置环节;87.7%（264例）的暴露类型为针刺伤;45.5%（137例）接触暴露源为有血源性传播疾病的患者。发生职业暴露工作人员中, 不同岗位职业暴露者的暴露类型、职位、科室、是否需要药物干预及接触暴露源情况比较差异有统计学意义（P<0.05）。结论 应加强医务工作者职业暴露相关知识及应急处置培训, 对不同工龄、岗位医务工作者制定针对性培训方案, 加强医疗废物处置流程及临床操作技能规范等知识培训,预防医务工作者职业暴露的发生。

Objective To analyze the characteristics,occupational exposure links, types, and treatment methods of occupational exposure among healthcare staff hospital, providing a theoretical basis for the development of related intervention strategies for hospitals．Methods A retrospective study was conducted to explore 301 cases of occupational exposure among healthcare staff in The People’s Hospital of Yuxi City from 2018 to 2023．Data of 301 cases were collected, including information on gender, age,department,personnel category, length of service in the hospital, job title, and the circumstances of occupational exposures, which covered exposure links, type, source, and post-exposure medication treatment measures．Results Among the 301 healthcare staff experiencing occupational exposure, the average age was（28.81±10.92）years, with 84.7%（255 cases）being female．Occupational exposure most frequently occurred during procedures such as examination, puncture, injection, blood collection, catheterization, treatment, and surgery（57.8%,174 cases）, followed by the disposal of medical waste（38.9%, 117 cases）．The primary type of exposure was needle-stick injury（87.7%）．Contact with patients suffering from blood-borne infectious diseases accounted for 45.5%（137 cases）of the occupational exposure incidents．There were significant differences in exposure types, job positions, departments, sources of exposure, and post-exposure medication treatment measures among healthcare staff of different categories（P<0.05）．Conclusions To prevent the occurrence of occupational exposure among healthcare staff, it is necessary to enhance training on occupational exposure knowledge and emergency management, particularly improving the disposal of medical waste and clinical operational skills．Additionally, it is crucial to have personalized training programs tailored to healthcare staff based on their varying lengths of service and positions．

目的 研究高尿酸（UA）和肥胖的交互作用对非酒精性脂肪肝病（NAFLD）患病率的影响。方法 采用病例对照的研究法,选取2021年1月至2021年12月兰州市某医院健康体检中心进行常规健康体检的504人为研究对象,按照诊断标准分为NAFLD组187人和非NAFLD 组317人。采用Logistic 回归模型、相乘、相加交互模型探讨非酒精性脂肪肝病患病风险的影响因素及因素间的交互作用。结果 多因素条件Logistic回归分析可知,肥胖（OR=4.87,95%CI：3.01~7.89）,糖尿病患者（OR=3.40,95%CI：1.51~7.68）,幽门螺杆菌（Hp）携带者（OR=1.62,95%CI：1.03~2.57）,高尿酸血症的NAFLD患病风险增加,分别是正常者、非糖尿病患者、非Hp携带者,非高尿酸血症的4.87倍,3.40倍,1.62倍,2.28倍,在调整混杂因素后交互作用结果显示,高尿酸血症和肥胖对NAFLD患病率有相乘交互作用（OR=0.30,95%CI：0.10~0.88,P=0.029）、但无相加交互作用（相对超额危险度比=3.15、归因比=0.24、协同指数=1.34）。结论 BMI、糖尿病、Hp是NAFLD患病的独立危险因素,其中高尿酸血症和超重与肥胖对NAFLD患病有相乘交互作用,无相加交互作用。

Objective To explore the influence of the interaction of high uric acid（UA）and obesity on the prevalence of non-alcoholic fatty liver disease（NAFLD）．Methods Using a case-control study method,504 people who underwent routine health checkups at the health checkup centre of a hospital in Lanzhou City from January 2021 to December 2021 were enrolled in the study,and 187 people were included in the NAFLD group and 317 people in the non-NAFLD group according to the diagnostic criteria．Logistic regression models,multiplicative and additive interaction models were used to investigate the factors affecting the risk factors of NAFLD and the interaction between the factors．Results Multifactorial conditional logistic regression analysis showed that the risk of NAFLD was increased in obese（OR=4.87,95% CI：3.01-7.89）,diabetic patients（OR=3.40,95% CI：1.51-7.68）,Helicobacter pylori（Hp）carriers（OR=1.62,95% CI：1.03-2.57）;the increased risk of NAFLD prevalence in hyperuricaemia patients was 4.87,3.40,1.62,and 2.28 times higher than that of normal,non-diabetic,non-Hp carriers,and non-hyperuricemic individuals,respectively．And the adjusted interaction showed a multiplicative interaction of hyperuricaemia and obesity on the prevalence of NAFLD after controlling for the confounders（OR=0.30,95% CI：0.10-0.88,P=0.029）,but no additive interaction （relative excess risk due to interaction=3.15,attributable proportion due to interaction=0.24,and synergy index=1.34） interactions．Conclusions BMI,diabetes mellitus,and Hp were independent risk factors for the prevalence of NAFLD,with hyperuricaemia and overweight and obesity having multiplicative interaction and no additive interaction．

目的 了解广州市某净水公司职工脂肪肝检出情况,并分析影响因素。方法 选取2023年广州市某净水公司参加职业健康检查的职工为研究对象,收集研究对象的一般情况、个人史、职业史、身体质量指数（BMI）、血压、血生化指标、肝脏彩超等资料。对该人群脂肪肝的患病情况进行描述性分析,对脂肪肝的影响因素进行单因素及多因素Logistic回归分析。结果 共收集研究对象1 217人,检出脂肪肝543例,检出率为44.62%。单因素分析结果表明,脂肪肝的发生与性别、年龄、体质量指数、高血压相关（P<0.05）。接触硫化氢、氨的职工脂肪肝检出率高于非接触者（P<0.05）,且职工工龄越长,脂肪肝检出率越高（P<0.05）。患脂肪肝职工的肝功能、脂代谢、血糖及尿酸水平高于非脂肪肝者（P<0.05）。多因素Logistic回归分析提示,年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸是脂肪肝的影响因素（P<0.05）。结论 广州市某净水公司职工的脂肪肝检出率较高,脂肪肝的发生主要与年龄、体质量指数、肝功能异常、脂代谢异常、高血糖、高尿酸等因素相关。

Objective To investigate the prevalence of fatty liver disease and influencing factors among employees of a water purification company in Guangzhou．Methods Employees of a water purification company in Guangzhou who participated in occupational health examinations in 2023 were selected as the study subjects．The subjects' general conditions,personal history,occupational history,BMI,blood pressure,blood biochemical indicators,and liver ultrasound images were collected．Descriptive analysis was used to analyze the prevalence of fatty liver disease in this population．The influencing factors of fatty liver were analyzed by single factor and multiple factor Logistic regression．Results A total of 1 217 subjects were included in this study,and 543 were diagnosed as fatty liver disease,with a detection rate of 44.62%．The results of single factor analysis showed that the occurrence of fatty liver was closely related to gender,age,BMI and hypertension（P<0.05）．The analysis of occupational hazard factors showed that,the detection rate of fatty liver disease was higher in people exposed to hydrogen sulfide and ammonia compared to non-exposed individuals（P<0.05）．The longer the working years,the higher the detection rate of fatty liver（P<0.05）．The levels of liver function,lipid metabolism,blood glucose and uric acid in workers with fatty liver were higher than those in workers without fatty liver（P<0.05）．Multivariate Logistic regression analysis showed that age,BMI,abnormal liver function,abnormal lipid metabolism,high blood glucose levels and hyperuricemia were independent influencing factors for fatty liver disease（P<0.05）．Conclusions The detection rate of fatty liver disease among employees of a water purification company in Guangzhou is high,and the occurrence of fatty liver disease is mainly related to factors such as age,BMI,abnormal liver function,abnormal lipid metabolism,high sugar levels and hyperuricemia．

目的 评估产后女性的认知功能,并分析其认知功能受损的特点,以及分析可能的影响因素。方法 病例组选取健康单胎足月顺产初产妇、二胎产妇,对照组选取一般资料匹配的未生育女性,选用蒙特利尔认知评估(Montreal Cognitive Assessment Test,MoCA)北京版、伯明翰认知评估量表(Birmingham Cognitive Screen test,BCoS)普通话版评估认知功能。结果 实际入组病例组80例产妇,均完成MoCA量表,共42例产妇完成BCoS量表,对照组30例均完成MoCA、 BCoS评估。产妇组(80例)MCA得分为(26.26±2.28)分,低于未生育女性对照组MoCA分数(27.47±1.28)分(P<0.05),产妇组认知障碍发生率为30%高于对照组6.7%(P<0.05)。初产妇组MoCA分数(26.52±2.13)分,认知障碍发生率为26%,二胎产妇组MoCA分数(25.83±2.49)分,认知障碍发生率为36.7%,两者对比无明显差别(P>0.05)。产妇组(80例)在MoCA量表视空间与执行功能分项得分低于对照组(P<0.01);产妇组BCoS评分在故事瞬时回想、苹果删除总数、听觉注意、规则转换、手势模仿5个分项低于对照组(P<0.05)。产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素(P<0.05)。结论 ①产后妇女可能发生认知功能障碍,但初产妇与二胎产妇的认知障碍发生率无明显差别。②MoCA量表可以用于产妇产后认知功能筛查,BCoS量表可做为全面评估产妇产后认知功能的工具,产妇产后认知受损主要在视空间、注意力、执行功能(实践与行动能力)、记忆力领域。③产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素。

Objective To evaluate the cognitive function of postpartum women, and analyze the characteristics of cognitive dysfunction and the possible affecting factors. Methods The case group selected healthy single-born full-term primiparae (50 cases) and second birth parturient (30 cases), and the control group (30 cases) selected non-fertile women with general data matching. The Montreal Cognitive Assessment Test (MoCA) Beijing version and Birmingham Cognitive Screen test(BCoS) were used to evaluate cognitive function. Results Of the 80 cases in the case group, all completed the MoCA test, only 42 cases completed the BCoS test. The 30 cases in the control group all completed the MoCA and BcoS.The MoCA score of the case group (80 cases) was (26.26±2.28), which was lower than that of the control group (27.47±1.28) (P<0.05). The incidence of cognitive impairment in the case group was 30%, higher than the control group 6.7% (P<0.05). The MoCA score of the primiparae group was (26.52±2.13); the incidence of cognitive impairment was 26%; the MoCA score of the second birth parturient group was (25.83±2.49); the incidence of cognitive impairment was 36.7%.There was no significant difference in the MoCA score and the incidence of cognitive impairment between primiparae and second birth parturient (P> 0.05).The case group had lower scores on visual space and executive function of MoCA test than the control group (P<0.01).The score of BCoS test in the case group was lower than that in the control group in the five items of the instantaneous recall item of the story, apple deletion, auditory attention, Birmingham rule conversion and gesture imitation (P<0.05).The years of education, labor analgesia, and the total duration of labor were the factors that affected the cognitive function of postpartum women (P<0.05). Conclusion ①Postpartum women may have cognitive dysfunction, but there was no significant difference in the incidence of cognitive impairment between primiparae and second birth parturient group. ②The MoCA test can be used for the screening of cognitive impairment of postpartum women, and the BCoS test can be used as a tool to comprehensively evaluate the cognitive function of postpartum women. The cognitive impairment of postpartum women was mainly in the fields of visual space, attention, executive function (practice and action ability), and memory. ③The years of education, labor analgesia, and the total duration of labor were the factors that affect the cognitive function of postpartum women.

目的 通过对不同职业人群前列腺疾病患病情况及相关危险因素进行分析,探讨不同职业人群前列腺疾病的患病率及相关危险因素。方法 选择2019年1月—2019年12月在我院健康管理中心进行前列腺超声检查的不同职业人群3 219例,按其职业分为5类:医务人员、国企职工、私企职工、高校教职工和银行职工,分析不同职业人群前列腺疾病患病情况及其相关影响因素。结果 3 219例受检者中,前列腺疾病的患病率为43.96%,前列腺疾病患病率随着年龄的增长而升高(P＜0.001);20～29岁及30～39岁年龄组前列腺钙化患病率均高于其他三种类型前列腺疾病(P＜0.001),而60岁以上年龄组前列腺增生和合并两种及以上前列腺疾病患病率均高于其他两种类型前列腺疾病(P＜0.001);前列腺增生和合并两种及以上前列腺疾病的患病率均随着年龄的增长而递增(P＜0.001);不同职业人群前列腺疾病的患病率不同(P＜0.001),银行职工的前列腺疾病患病率最高,为52.36%;体质量指数升高组、血压升高组和血脂升高组的前列腺钙化患病率均高于其对应的正常组(P＜0.05);体质量指数升高组、血糖升高组、血压升高组和血脂升高组的前列腺增生患病率均高于其对应的正常组(P＜0.001)。结论 不同的职业群体前列腺疾病的患病情况不一样,体质量指数升高、血压升高、血脂升高及血糖升高等相关因素增加患前列腺疾病的风险,应加强前列腺疾病预防保健方面的健康宣传,提倡健康的生活方式,从而降低前列腺疾病的患病率。

Objective To study on epidemic situation of prostate disease and related risk factors in different occupational groups by analyzing the prevalence and related risk factors of prostate disease in different occupational groups. Methods 3 219 cases of five different occupations including medical staffs, state-owned enterprise staffs, private enterprise staffs,college staffs and bank staffs who had underwent prostate ultrasonography in the health management centre department of the Fifth Affiliated Hospital of Guangzhou Medical University from January 2019 to December 2019 were included as study objects to analyze the prevalence of prostate disease and its related factors in different occupational groups. Results The prevalence of prostate disease was 43.96% in 3 219 cases of different occupational groups, and the prevalence of prostate disease increased greatly with age(P＜0.001). The detection rates of prostate calcification in the age group of 20-29 and 30-39 were greatly higher than the other three types of prostate diseases(P＜0.001). The detection rate of BPH and with two or more prostate diseases in the age group over 60 years old was greatly higher than the other two types of prostate diseases(P＜0.001);The detection rates of BPH and with two or more prostate diseases were significantly increased with age (P＜0.001). There was an obvious difference inthe prevalence of prostate diseasesamong different occupational groups(P＜0.001). The prevalence of prostate disease in bank staffs was 52.36%, which was the highest among the five occupations. The prevalence of prostate calcification in the group with high body mass index, high blood pressure and high blood lipid were greatly higher than that of their normal group(P＜0.05). The prevalence of BPH in the group with high body mass index, high blood glucose, high blood pressure and high blood lipid were higher than that of their greatly normal group(P＜0.001). Conclusions The prevalence of prostate diseases is different among different occupational groups. Relative factors such as high body mass index, high blood glucose, high blood pressure and high blood lipid will increase the risk of prostate disease. By strengthening the health promotion of prostate disease prevention and health care, promoting a healthy lifestyle, it may reduce the prevalence of prostate disease.

目的 本研究通过调查中国华南地区一间大型医疗机构(综合医院)中护士日间过度嗜睡的发生率及相关影响因素。方法 纳入了1 102名在职护士要求他们在一段规定的时间内完成一份自我报告问卷,其中包括人口学资料采集、生活习惯(BMI、小睡习惯、打鼾等)、失眠、抑郁、焦虑、MEQ分型、倒班、工作兴趣等与工作及睡眠相关的特征。了解EDS在被试人群中的发生率及其影响因素。结果 共有1 048名护士有效的完成了问卷(应答率为95.1%)。其中169名(16.1%)护士存在日间过度嗜睡(EDS)。抑郁症状(校正后的OR值= 2.24,95%的可信区间 1.51～3.31)、焦虑症状(1.65; 1.02～2.67)、失眠(2.29; 1.56～3.36)、倒班工作(1.98; 1.03～3.83)和对工作的低兴趣(1.74; 1.01～2.99)是EDS发生的独立危险因素。结论 日间过度嗜睡(EDS)在华南地区的综合医疗机构中的青年护士群体中普遍存在。EDS的发生可能与抑郁症状、焦虑症状、失眠、倒班工作和对工作的低兴趣存在相关。

Objective To investigate the prevalence and correlates of excessive daytime sleepiness EDS in a population of hospital nurses in South China. Methods A total of 1 102 nurses working in a large medical center were invited to participate in this cross-sectional study (females 96.9%,mean age 29.6 years). They all completed a self-reported questionnaire consisting of items on demographic variables,lifestyle factors,insomnia,anxiety,depression,and both work-related and sleep related characteristics. Results A total of 1 048 nurses gave a valid response (response rate 95.1%). Among them,169 (16.1%) reported EDS as defined as an Epworth Sleepiness Scale≥14. Depression (adjusted odds ratio=2.24,95% confidence interval 1.51～3.31),anxiety (1.65; 1.02 ～2.67),insomnia (2.29; 1.56～3.36),rotating shift work (1.98; 1.03～3.83) and low interest in work (1.74; 1.01～2.99) were all independent risk factors of the occurrence of EDS. Conclusion EDS were common among this relatively young and healthy nurse population in south China. There were clear associations with EDS and depression,anxiety,insomnia,rotating shift work and low work-related interest.

目的 分析惠州地区高尿酸血症患病率,探讨血清雌二醇水平与高尿酸症之间的相关性。方法 选择惠州市第一人民医院500名体检人员为研究对象,检测血清中尿酸浓度,女性同时检测雌二醇。结果 惠州地区高尿酸血症总患病率为23.2%(116/500),男性及女性分别为27.91%(72/258)和18.18%(44/242)(χ²＝6.628,P=0.010),不同性别血清尿酸浓度差异显著(Z=-15.961,P<0.001)。各年龄段男性血清尿酸水平(χ²=6.432,P=0.169)及患病率(χ²＝3.989,P=0.408)均相近。50岁以上女性患病率与男性无差异(χ²=0.088,P=0.766),20～49岁女性血清尿酸水平(Z=-3.856,P<0.001)及患病率(χ²=9.532,P=0.002)均低于50岁以上女性。20～49岁女性雌二醇高于50岁以上女性(Z＝-6.171,P<0.001),尿酸与雌二醇具有负相关性,r=-0.464。结论 除50岁以上女性外,惠州地区健康人群高尿酸血症患病率与国内多数地区人群相近,女性50岁进入绝经期后高尿酸血症患病率的快速上升与体内雌激素下降呈负相关。

Objective To analyze the prevalence rate of hyperuricemia (HUA) in Huizhou and investigate the relationship between HUA and estradiol(E2). Methods 500 health people from Huizhou first hospital were enrolled. Uric acid and E2 in female was detected. Results The overall prevalence rate of HUA was 23.2%(116/500). The prevalence rate of male and female were 27.91% (72/258)and 18.18%(44/242), respectively(χ²＝6.628,P=0.010). There was no significantly difference between male and female in the level of uric acid(Z=-15.961,P<0.001) The levels ofuricacid in serum(χ²=6.432,P=0.169)and the prevalence rate (χ²＝1.1,P>0.05)were closed to each age bracket in male group. The prevalence rate of male over 50 years old was closed to female(χ²=0.0144,P>0.05).In 20 to 49 years old female group, prevalence rate was lower(χ²=6.084,P<0.025) and uric acid in serum(χ²=17.599,P<0.001)was lower than that of the group over 50 years old. The levels of E2 of female under 50 years old was higher than that above 50 years old(χ²＝41.292,P<0.001).There was negative correlation between uric acid and E2, and the correlation coefficient was -0.464. Conclusion The prevalence rate of HUA in Huizhou is close to most area in China except female over 50 years old. After menopause, the rapid rise of prevalence rate of HUA in female is associated with the descending of E2.

目的 对从淡水养殖鱼类、青蛙样品以及腹泻病人大便样品分离的菌株作临床常用抗生素的耐药性分析,为相关疾病的治疗提供实验依据。方法 获取临床腹泻病人的新鲜大便标本和在水产品市场采集淡水鱼和青蛙样品取肠道内含物分别涂布选择性培养基,选取疑似菌落进行生化鉴定和16S rRNA基因分子鉴定,确证为香港海鸥型菌的菌株采用纸片扩散法测定分离株对几类临床常见抗菌药物的敏感性。结果 本次检测的24株香港海鸥型菌分离株对八种常用的抗生素药物表现不同程度的耐药性。蛙源株对环丙沙星、阿米卡星、头孢他啶的耐药率高于鱼源株。其中分离的11株分离株(45.8%)对3个种类及以上抗生素表现耐药,为多重耐药株。结论 抗生素作为促生长剂和动物疾病防治被广泛加于动物饲料中,可能导致食源性细菌耐药性增加。人们有可能通过摄入含有香港海鸥型多重耐药株污染的食物而获得抗生素耐药性的潜在危险。

目的 调查重症监护病房(ICU)医院感染的常见细菌分布及耐药性变化,为合理使用抗生素和医院感染的预防控制提供相关科学依据。方法 回顾性分析医院2007—2011年ICU收治的381医院感染患者感染菌株分布特点及耐药性情况。结果 ICU医院感染常见菌株主要来源于痰液标本,占78.2%,其次是血液。381 株临床分离菌中共检出革兰阴性杆菌262 株、革兰氏阳性球菌70例和真菌49例,分别占68. 8%、24.9%和占17.4%。革兰阴性杆菌中鲍氏不动杆菌(24.7%)、肺炎克雷伯氏杆菌(10.8%)、铜绿假单胞菌(9.2%)排前三位。其中除碳青霉烯类药物及抑酶制剂,鲍氏不动杆菌对其余抗菌药物耐药率均＞40%。革兰氏阳性球菌以金黄色葡萄球菌为主。对青霉素、庆大霉素、红霉素的耐药率均＞50%。结论 呼吸道仍是ICU最常见的感染部位。病原菌以革兰阴性杆菌为主,且对常用抗菌药物的耐药率逐渐升高,临床应加强抗菌药物规范使用,避免耐药菌株的产生。

Objective To investigate the distribution and drug resistance of pathogens in intensive care unit(ICU)causing nosocomial infections so as to provide scientific basis for antibiotic adoption and the prevention and control of nosocomial infections. Methods The specimen sources and the clinical distribution of the 381 pathogens isolated from 2007 to 2011 were retrospectively analyzed. The drug resistance was observed in ICU that causing nosocomial infections. Results The sputum was the major specimens source in ICU, accounting for 78.2%. Of the 381 pathogens causing nosocomial infections in ICU, the 262 gram-negative bacilli (68.8%), 70 gram-positive cocci (24.9%),and 49 fungi (17.4) were isolated, Among gram-negative bacilli the top three were acinetobacter baumannii (24.7%), klebsiella pneumonia(10.8%),and pseudomonas aeruginosa (9.2%). The drug resisitance rate of baumannii to antibiotics were more than 40%,beside carbapenem and B-Lactamaseinhibitors. The main gram-positive cocci of causing nosocomial infections was saphylococcus aureus in ICU. The drug resisitance rate of S. aureus to penicillin, erythromycin and gentamicin were higher than 50.0%. Conclusion The main distribution area of nosocomial infections was the respiratory tract and the gram-negative bacilli were the common pathogens in ICU. It was benefit to avoid presenting of drug resistant strain, and antibiotics should be reasonably used in clinic.