内分泌科住院患者多重耐药菌感染及抗生素使用情况  

Multi-drug resistant bacteria infection and antibiotic use in inpatients in endocrinology department

作　　者：田勇[1] 丁红霞[1] 李进[1] 刘艳晓[1] 王俊宏[1] TIAN Yong;DING Hong-xia;LI Jin;LIU Yan-xiao;WANG Jun-hong(The First People′s Hospital of Henan Pingdingshan,Pingdingshan 467000,Henan,China)

机构地区：[1]河南省平顶山市第一人民医院,河南平顶山467000

出　　处：《中国病原生物学杂志》2022年第1期114-117,共4页Journal of Pathogen Biology

摘　　要：目的分析内分泌科住院患者多重耐药菌感染及抗生素使用情况,指导临床抗感染防控。方法收集2015-2018年本院内分泌科就诊的患者临床资料。采用全自动细菌分析系统对病原菌类型进行鉴定,同时采用该系统对病原菌进行药敏试验。采用PCR扩增检测主要多重耐药菌的耐药基因。结果从多重耐药菌感染患者中分离85株多重耐药菌,革兰阴性菌60株,其中大肠埃希菌34株,肺炎克雷伯菌17株,鲍曼不动杆菌9株。革兰阳性菌25株,其中金黄色葡萄球菌16株,溶血葡萄球菌9株。2015年未检出多重耐药菌,2016-2018年分离菌株分别为18、30和37株。从尿液、痰液、血液以及伤口分泌物中分离的多重耐药菌分别为40、24、13和8株,占47.06%、28.24%、15.29%和9.41%。大肠埃希菌中IntI 1基因、I类整合子、遗传标记基因、acra基因、acrb基因的阳性检出率分别为23.53%、73.53%、50.00%、55.88%和47.06%。金黄色葡萄球菌中mecA、qacA、ermC、qacA+ermC、mecA+qacA+ermC、icaA、icaD基因的阳性检出率分别为50.00%、62.50%、43.75%、12.50%、37.50%、43.75%和31.25%。2015-2018年多重耐药菌总感染率为5.88%,各年份多重耐药菌感染率为0.00%、6.19%、5.60%和8.72%。结论2016-2018年患者感染多重耐药菌呈整体增多趋势,并且感染主要发生在患者尿液样本。积极监测多重耐药菌中耐药基因分布情况,对控制多重耐药菌流行传播具有重要意义。Objective The multi-drug resistant bacteria infection and antibiotic use in inpatients in endocrinology department were analyzed to guide prevention and control of clinical anti-infection.Methods Clinical data of patients admitted to the department of endocrinology of our hospital from 2015 to 2018 were collected.The pathogen types were identified by the automatic bacterial analysis system and the drug susceptibility test was carried out.PCR amplification was used to detect the drug-resistant genes of multi-drug resistant strains.Results 85 strains of multi-drug resistant bacteria were isolated from infected patients.There were 60 strains of Gram-negative bacteria,including 34 strains of Escherichia coli,17 strains of Klebsiella pneumoniae and 9 strains of Acinetobacter baumannii.There were 25 strains of Gram-positive bacteria,including 16 strains of Staphylococcus aureus and 9 strains of hemolytic Staphylococcus.No multi-drug resistant bacteria infection was found in patients in 2015.From 2016 to 2018,18,30 and 37 strains were isolated respectively.The proportion of multi-drug resistant bacteria isolated from urine,sputum,blood and wound secretions was 47.06%,28.24%,15.29%,and 9.41%,respectively.The positive detection rates of IntI 1 gene,class I integrin,genetic marker genes,acra,acrb in E.coli were 23.53%,73.53%,50.00%,55.88%,47.06%,respectively.The positive detection rates of mecA,qacA,ermC,qacA+ermC,mecA+qacA+ermC,icaA,icaD in S.aureus were 50.00%,62.50%,43.75%,12.50%,37.50%,43.75%,31.25%,respectively.From 2015 to 2018,the total infection rate of multi-drug resistant bacteria was 5.88%,and the infection rates of multi-drug resistant bacteria in inpatients in endocrinology department were 0.00%,6.19%,5.60%,8.72%in each year.Conclusion From 2016 to 2018,there was an overall increasing trend of patients infected with multi-drug resistant bacteria,and the infection mainly occurred in the urine samples of patients.The infection types of multi-drug resistant bacteria in inpatients in endocrinology department were

关 键 词：内分泌科 住院患者 多重耐药菌感染 耐药基因 

分 类 号：R378[医药卫生—病原生物学]