某医院院内感染革兰阴性菌分布及耐药性分析  

Analysis of distribution and drug resistance of gram-negative bacteria in nosocomial infection of a hospital

作　　者：雷世鑫 李宏科 脱鸣富 习静 戴红因 LEI Shi-xin;LI Hong-ke;TUO Ming-fu;XI Jing;DAI Hong-yin(Gansu Medical College,Pinliang Gansu 744000;Affiliated Hospital of Gansu Medical College,China)

机构地区：[1]甘肃医学院,甘肃平凉744000 [2]甘肃医学院附属医院

出　　处：《中国消毒学杂志》2020年第4期280-283,共4页Chinese Journal of Disinfection

基　　金：甘肃省高等学校科研项目(2018A-147)。

摘　　要：目的分析甘肃医学院附属医院院内感染革兰阴性菌分布及耐药性趋势。方法回顾性分析2009-2018年间甘肃医学院附属医院革兰阴性菌感染的分离率、病原菌分布及耐药率的趋势。结果革兰阴性菌分离率呈迂回上升趋势;常见标本中,咽拭子的革兰阴性菌分离率呈下降趋势,而脑脊液、穿刺液和分泌物的分离率呈上升趋势;革兰阴性菌以大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌为主,鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌分离率呈上升趋势,产ESBL菌株分离率呈增长趋势;肠杆菌科和不动杆菌科细菌头孢哌酮舒巴坦、亚胺培南、美罗培南和阿米卡星的耐药率较低,但头孢哌酮舒巴坦、亚胺培南和美罗培南的耐药率呈上升趋势,阿米卡星的耐药率有所下降。结论大肠埃希菌、鲍曼不动杆菌和肺炎克雷伯菌是常见革兰阴性菌,鲍曼不动杆菌、铜绿假单胞菌和嗜麦芽窄食单胞菌分离率呈增长趋势,分离率从61. 86%上升至73. 82%。药敏显示常见细菌对抗菌药物的耐药率呈上升趋势。Objective To analyze the distribution and trend of drug resistance of Gram-negative bacteria in nosocomial infection of Affiliated Hospital of Gansu Medical College. Methods The isolation rate,pathogen distribution and rate of drug resistance Gram-negative bacteria infections in Affiliated Hospital of Gansu Medical College from 2009 to 2018 were retrospectively analyzed. Results The isolation rate of Gram-negative bacteria showed a circuitous upward trend;in common specimens,the isolation rate of Gram-negative bacteria from throat swabs showed a downward trend,while that of cerebrospinal fluid,puncture fluid and secretions showed an upward trend;Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii were the main Gram-negative bacteria,and the isolation rates of Acinetobacter baumannii,Pseudomonas aeruginosa and Stenotrophomonas maltophilia as well as that of ESBL-producing strains showed a upward trend;the resistance rates of Enterobacteriaceae and Acinetobacter to cefoperazone sulbactam,imipenem,meropenem and amikacin were lower,but the resistance rates of cefoperazone sulbactam,imipenem and meropenem was on the rise,while that of amikacin was on the decline. Conclusion Escherichia coli,Acinetobacter baumannii and Klebsiella pneumoniae are common Gram-negative bacteria. The isolation rate of Acinetobacter baumannii,Pseudomonas aeruginosa and Stenotrophomonas maltophilia increased from 61. 86% to 73. 82%. Drug sensitivity test showed that the resistance rate of common bacteria to antibiotics was on the rise.

关 键 词：革兰阴性菌 病原菌分布 耐药率 

分 类 号：R446.5[医药卫生—诊断学]