某院2016年-2019年间663例重症医学科患者各标本中感染病原菌的分布及其耐药性分析  

Analysis on Distribution and Drug Resistance of Pathogenic Bacteria Infected in 663 Patients of ICU in a Hospital From 2016 to 2019

作　　者：方海宏 曾振华[2] FANG Hai-hong;ZENG Zhen-hua(Department of Anesthesiology,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China;Department of critical care,Nanfang Hospital,Southern Medical University,Guangzhou 510515,China)

机构地区：[1]南方医科大学南方医院麻醉科,广州510515 [2]南方医科大学南方医院重症医学科,广州510515

出　　处：《抗感染药学》2021年第5期634-639,共6页Anti-infection Pharmacy

基　　金：国家自然科学基金资助项目(编号:81701955)。

摘　　要：目的:分析医院2016年—2019年间重症医学科(ICU)患者感染病原菌的分布及其耐药特点,为制定抗菌药物治疗方案提供参考。方法:抽取医院2016年1月—2019年8月ICU收治的重症感染患者663例病历中病原学检测的相关资料,统计其患者各标本中病原菌的培养、分布及其药敏试验结果,分析其病原菌的分布及其对不同抗菌药物的耐药特点。结果:663例重症感染患者标本中,分离出1 055株病原菌,其中革兰阴性杆菌占55.73%(以不动杆菌属为主)、革兰阳性球菌占22.75%(以屎肠球菌为主)和真菌占21.52%(以白假丝酵母为主);药敏试验结果发现,大多病原菌均呈多重耐药,多重耐药和泛耐药的不动杆菌属对氨苄西林、氨曲南、头孢唑林的耐药率均达100.00%,铜绿假单胞菌对氨苄西林、头孢唑林、阿莫西林-克拉维酸钾、氨苄西林-舒巴坦钠的耐药率高达100.00%。结论:医院ICU耐药菌感染有增多趋势,以不动杆菌属和耐甲氧西林凝固酶阴性葡萄球菌感染为主,这可能与新型抗菌药物(如替加环素等)的广泛使用和侵入性操作的增多有关,临床应加强对病原菌的耐药检测,合理使用抗菌药物,遏制耐药菌株的产生。Objective: To analyze the distribution and drug resistance characteristics of pathogenic bacteria in ICU patients from 2016 to 2019, and to provide reference for the formulation of antibacterial medication program. Methods:The relevant data of etiological detection in the medical records of 663 patients with severe infection admitted to ICU from January 2016 to August 2019 were selected, and the culture, distribution and drug sensitivity test results of the pathogens in each specimen of the patients were statistically analyzed;the distribution of the pathogens and the characteristics of their resistance to different antibacterial agents were analyzed. Results: In the 663 patients with severe infection, 1 055 strains of pathogenic bacteria were isolated, of which 55.73% were Gram-negative bacilli(Acinetobacter),22.75% were Gram-positive cocci(Enterococcus faecium) and 21.52% were fungi(Candida albicans).Drug sensitivity test results showed that most of the pathogens were multi-drug resistant organism(MDRO), MDRO and Pan-drug resistant Acinetobacter to ampicillin, aztreonam, cefazolin resistance rate were all up to 100.00%, Pseudomonas aeruginosa to ampicillin, cefazolin, amoxicillin-clavulanate, ampicillin-sulbactam resistance rate was up to 100.00%. Conclusion:hospital ICU drug-resistant bacteria infection had increased tendency, with acinetobacter and methicillin-resistant coagulase negative Staphylococcus infection was given priority to, this may be related to new antibacterial drugs(such as tigecycline and so on) increase in the number of widely used and invasive operation;clinically, drug resistance detection of pathogenic bacteria should be strengthened, and rational use of antibacterial agents should be used to curb the generation of drug-resistant strains.

关 键 词：重症监护室 抗菌药物耐药性 医院感染 肺炎 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]