滨州市中心医院抗生素的使用情况及感染病原菌和细菌耐药性的调查分析  

The use of antibiotics in Binzhou Central Hospital and the investigation and analysis of infectious pathogens and bacterial resistance

作　　者：赵新惠[1] 刘敏[1] 王建[1] 张国翠 Zhao Xinhui;Liu Min;Wang Jian;Zhang Guocui(Department of Laboratory Medicine,Binzhou Central Hospital,Binzhou 251700,China)

机构地区：[1]滨州市中心医院检验科,山东滨州251700

出　　处：《中国临床实用医学》2021年第1期61-64,共4页China Clinical Practical Medicine

摘　　要：目的探究滨州市中心医院抗生素的使用情况及感染病原菌、细菌耐药性的调查结果。方法滨州市中心医院检验科对2019年4月至2020年4月滨州市中心医院收治的13 982例住院患者的抗生素使用情况进行回顾性分析,男7 684例,女6 298例,年龄(40.25±8.99)岁,年龄范围为18~71岁,检测分析感染病原菌的类型、病原菌中病原微生物的构成情况、常见革兰氏阳性菌和革兰氏阴性菌的细菌耐药性。结果 13 982份标本中,分离出阳性样本1 453份,阳性率10.39%(1 453/13 982)。阳性样本中共分离出病原微生物共1 672株,其中革兰氏阳性菌442株、革兰氏阴性菌925株、真菌202株、病毒103株。在常见的革兰氏阳性菌当中,金黄色葡萄球菌、表皮葡萄球菌、屎肠球菌及粪肠球菌对阿奇霉素、苯唑西林、红霉素、青霉素、环丙沙星、头孢唑林、左氧氟沙星具有明显耐药性,差异有统计学意义(P<0.05),对万古霉素、氯霉素、莫西沙星不具有明显的耐药性,差异无统计学意义(P>0.05)。在常见的革兰氏阴性菌当中,铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌、鲍曼不动杆菌、阴沟肠杆菌对氨苄西林、美洛西林、头孢哌酮、头孢噻肟、头孢曲松、头孢吡肟、氨曲南、环丙沙星、头孢他啶具有明显耐药性,差异有统计学意义(P<0.05),对美罗培南、阿米卡星不具有明显的耐药性,差异无统计学意义(P>0.05)。结论抗生素的不合理使用能够增加病原菌的耐药率,通过对常见的病原菌进行有效的药敏试验,结合试验结果选择敏感性较高的药物能够为临床合理用药提供可靠依据。Objective To investigate the use of antibiotics and infectious pathogen,bacterial resistance investigation results in Binzhou Central Hospital.Methods A retrospective study was performed on 13982 cases of patients who were admitted in department of Laboratory Medicine,Binzhou Central Hospital and given antibiotics from April 2019 to April 2020.There were 7684 males and 6298 females,aged(40.25±8.99)years old,ranging from 18 to 71 years old.The types of pathogenic bacteria,the composition of pathogenic microorganisms,and the bacterial resistance of common Gram-positive bacteria and Gram-negative bacteria were analyzed.Results Among 13982 samples,1453 positive samples were isolated,with a positive rate of 10.39%(1453/13982).A total of 1672 pathogenic microorganisms were isolated from the positive samples,including 442 strains of Gram-positive bacteria,925 strains of Gram-negative bacteria,202 strains of fungi and 103 strains of viruses.In the common Gram-positive bacteria,Staphylococcus aureus,Staphylococcus epidermidis,Enterococcus faecium and Enterococcus faecalis were significantly resistant to Azithromycin,Oxacillin,Erythromycin,Penicillin,Ciprofloxacin,Cefazolin and Levofloxacin,and the difference was statistically significant(P<0.05).There was no significant difference in resistance to Vancomycin,Chloramphenicol and Moxifloxacin(P>0.05).In the common Gram-negative,Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli,Acinetobacter baumannii,Enterobacter cloacae were significantly resistant to Ampicillin,Meloxicillin,Cefoperazone,Cefotaxime,Ceftriaxone,Cefepime,Aztreonam,Ciprofloxacin and Ceftazidime(P<0.05).There was no significant difference in drug resistance to Meropenem and Amikacin(P>0.05).Conclusion The unreasonable use of antibiotics can increase the drug resistance rate of pathogenic bacteria.By conducting effective drug sensitivity tests on common pathogenic bacteria and combining with the test results,the selection of drugs with higher sensitivity can provide a reliable basis for rational cl

关 键 词：抗生素 病原菌 细菌耐药性 革兰氏阳性菌 革兰氏阴性菌 

分 类 号：R446.5[医药卫生—诊断学]