2020年新乡市某三级医院病原菌分布与耐药情况分析  

Analysis of distribution and drug resistance of pathogens in a tertiary hospital in Xinxiang city in 2020

作　　者：张莉莉[1] 丁华夏 辛佳桧 王妍妍[1] 张铁汉[1] 赵永新[1] ZHANG Lili;DING Huaxia;XIN Jiahui;WANG Yanyan;ZHANG Tiehan;ZHAO Yongxin(Clinical Laboratory Department,the Third Affiliated Hospital of Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]新乡医学院第三附属医院检验科,河南新乡453003

出　　处：《临床医学研究与实践》2022年第4期1-4,9,共5页Clinical Research and Practice

基　　金：二○一八年度河南省医学科技攻关计划项目(No.2018010017)。

摘　　要：目的了解新乡市某三级医院各临床科室2020年所有标本分离病原菌的分布及耐药情况,为临床经验性抗感染治疗及医院感染防控提供理论依据。方法分析本院2020年临床送检标本分离出的病原菌及药敏试验结果。结果2020年共分离出1 465株细菌,送检的阳性标本类型中痰液标本数量居首位,其次是尿液、血液、分泌物、腹水等。革兰阳性球菌占23.7%,革兰阴性杆菌占76.3%,其中大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌位居前5位。耐碳青霉烯类肠杆菌科细菌(CRE)总检出率为1.9%(7/378);耐碳青霉烯类肺炎克雷伯菌(CRKP)检出率为5.2%(12/230);非发酵细菌铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率可达19.4%和78.2%。葡萄球菌属中,MRCNS的检出率为63.0%,MRSA的检出率为34.1%,未发现耐万古霉素、替考拉宁的葡萄球菌。肠球菌属中,屎肠球菌的检出率及耐药率基本上高于粪肠球菌,未发现耐万古霉素及利奈唑胺的肠球菌。结论分离病原菌种类不同,其耐药性差异大。目前临床上耐药形势严峻,应根据耐药监测结果合理使用抗菌药物,减缓细菌耐药性的产生。Objective To understand the distribution and drug resistance of pathogens isolated from all specimens in clinical departments of a tertiary hospital in Xinxiang city in 2020, so as to provide theoretical basis for clinical anti-infection treatment and prevention and control of nosocomial infection. Methods The pathogens isolated from clinical samples submitted for examination in the hospital in 2020 and the drug sensitivity test results were analyzed. Results In 2020, a total of 1 465 strains of bacteria were isolated. Among the types of positive samples submitted for examination,the number of sputum specimens ranked first, followed by urine, blood, secretions, ascites, etc. Gram positive cocci accounted for 23.7% and gram negative bacilli accounted for 76.3%, among which Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Coagulase Negative Staphylococcus and Staphylococcus aureus were the top 5. The total detection rate of carbapenem resistant Enterobacteriaceae(CRE) was 1.9%(7/378);the detection rate of carbapenem resistant Klebsiella pneumoniae(CRKP) was 5.2%(12/230);the resistance rates of non fermenting bacteria Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenems were 19.4% and 78.2%. In Staphylococcus, the detection rate of MRCNS was 63.0%, and the detection rate of MRSA was 34.1%. No vancomycin-resistant and teicoplanin-resistant Staphylococcus was found. Among Enterococcus, the detection rate and drug resistance rate of Enterococcus faecium were basically higher than those of Enterococcus faecium, and no Enterococcus resistant to vancomycin and linezolid were found. Conclusion There are great differences in drug resistance among different types of isolated pathogens. At present,the clinical situation of drug resistance is severe. Antibiotics should be used reasonably according to the drug resistance monitoring results to slow down the emergence of bacterial drug resistance.

关 键 词：病原菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]