2018年江苏省某三甲医院临床细菌分布及耐药性分析  

Distribution of clinical pathogens and analysis of drug resistance in a grade-A tertiary hospital of Jiangsu Province in 2018

作　　者：朱文杰[1] 张翔[2] 黄友 谢春华[1] 王福彪[1] 祖荣强[3] 周印[4] ZHU Wenjie;ZHANG Xiang;HUANG You;XIE Chunhua;WANG Fubiao;ZU Rongqiang;ZHOU Yin(Yangzhou Hanjiang District Center for Disease Control and Prevention,Jiangsu 225000,China;不详)

机构地区：[1]扬州市邗江区疾病预防控制中心,江苏225000 [2]南京医科大学第一附属医院(江苏省人民医院) [3]江苏省疾病预防控制中心 [4]镇江市疾病预防控制中心

出　　处：《医学动物防制》2020年第11期1105-1108,1112,共5页Journal of Medical Pest Control

基　　金：中国老年医学学会感染防控研究基金资助项目(GRYJ-XL2018009,GRYJ-XL2018016);国家重点研发计划基金资助项目(2018YFC1314900,2018YFC1314901);江苏高校优势学科建设工程资助项目(JX10231802)。

摘　　要：目的分析医院常见病原菌及其耐药情况,为临床合理使用抗菌药物提供依据。方法对2018年医院临床分离的病原菌进行回顾性分析。结果11324株病原菌中,革兰阴性菌7023株(62.02%),革兰阳性菌2152株(19.00%),真菌2149株(18.98%)。所有分离菌居前3位的分别为大肠埃希氏菌、肺炎克雷伯菌和鲍曼不动杆菌。61.01%的大肠埃希氏菌引起尿路感染;肺炎克雷伯菌对头孢噻肟、头孢西丁、呋喃妥因和米诺环素的耐药率较2017年分别升高13.6%、11.4%、12.4%和24.6%;鲍曼不动杆菌和铜绿假单胞菌的碳青霉烯耐药菌株分别占80.91%和42.32%;耐甲氧西林金黄色葡萄球菌检出率为53.85%;粪肠球菌和屎肠球菌只对利奈唑胺和万古霉素保持较高敏感率(>98%)。结论2018年某三甲医院临床病原菌主要为革兰阴性菌,对常用抗菌药物耐药率均较高,应根据细菌耐药情况合理选择抗菌药物。Objective To analyze common pathogens and their drug resistance so as to provide evidence for clinically rational use of antibacterial drugs.Methods A retrospective analysis of the pathogens isolated from the hospital in 2018 was conducted.Results Among the 11324 pathogen strains,7023 strains of Gram-negative bacilli(62.02%),2152(19.00%)strains of Gram-positive bacilli and 2149 strains of fungi(18.98%).The top three of all isolated strains were Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii.61.01%Escherichia coli caused urinary tract infection.Drug resistance rates of Klebsiella pneumoniae to cefotaxime,cefoxitin,macrodantin and minocycline increased by 13.6%,11.4%,12.4%and 24.6%,respectively.Carbapenem resistant strains of Acinetobacter baumannii and pseudomonas aeruginosa accounted for 80.91%and 42.32%,respectively.The detection rate of Methicillin-resistant Staphylococcus aureus was 53.85%.Enterococcus faecalis and Enterococcus faecium only remained a high sensitivity(>98%)to linezolid and vancomycin.Conclusion The most common clinical pathogen in a grade-A tertiary hospital is Gram-negative bacilli,which is greatly resistant to commonly used antibacterial agents.And the antibacterial agents should be chosen according to the drug resistance state.

关 键 词：三甲医院 细菌 耐药性 抗菌药物 感染 

分 类 号：R378[医药卫生—病原生物学]