陕西省公立医院与民营医院ICU感染病原菌分布特点及耐药性差异分析  

Analysis on differences in distribution characteristics and drug resistance of pathogenic bacteria in ICU infection between public and private hospitals in Shaanxi Province

作　　者：刘海萍 韩蕾 王翠 韩蓓 王洪亮 LIU Haiping;HAN Lei;WANG Cui;HAN Bei;WANG Hongliang(Department of Clinical Laboratory,Xi'an Daxing Hospital,Xi'an,Shaanxi 710014,China;Faculty of Pathogenic Biology and Immunology,School of Basic Medicine,Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China;Department of Clinical Laboratory,Shaanxi Provincial People's Hospital,Xi'an,Shaanxi 710068,China;Faculty of Nutrition and Food Safety,School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an,Shaanxi 710061,China)

机构地区：[1]西安大兴医院检验科,陕西西安710014 [2]西安交通大学医学部基础医学院病原生物学与免疫学系,陕西西安710061 [3]陕西省人民医院检验科,陕西西安710068 [4]西安交通大学医学部公共卫生学院营养与食品安全系,陕西西安710061

出　　处：《检验医学与临床》2022年第11期1458-1462,共5页Laboratory Medicine and Clinic

基　　金：国家自然科学基金青年科学基金项目(81702043)。

摘　　要：目的通过分析陕西省所有公立三级医院重症监护室(ICU)和民营三级医院ICU临床病原菌流行特点,了解不同属性医疗机构ICU标本来源、细菌种类以及耐药率的差异。方法回顾性分析2019年1月至2020年12月陕西省49家公立三级医院、4家民营三级医院上报至陕西省细菌耐药监测网的ICU数据,采用WHONET5.6和SPSS22.0软件进行数据分析,了解不同类型三级医院ICU标本来源、细菌种类、主要致病菌耐药性是否存在差异。结果公立三级医院和民营三级医院ICU标本来源均以呼吸道标本为主,其中公立医院ICU痰液标本占比远高于民营医院(P<0.05),但肺泡灌洗液占比低于民营医院(P<0.05)。公立三级医院ICU和民营三级医院ICU检出菌均以革兰阴性菌为主,分别占78.3%、79.3%。民营三级医院ICU肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率均高于公立三级医院ICU(P<0.05)。公立三级医院ICU鲍曼不动杆菌、铜绿假单胞菌对碳青霉烯类抗菌药物的耐药率高于民营三级医院ICU(P<0.05)。公立三级医院ICU金黄色葡萄球菌对红霉素、头孢西丁的耐药率高于民营三级医院ICU(P<0.05)。公立三级医院ICU屎肠球菌对高浓度链霉素、高浓度庆大霉素耐药率高于民营三级医院ICU(P<0.05),对四环素的耐药率恰恰相反(P<0.05)。结论公立三级医院ICU和民营三级医院ICU的标本来源、细菌种类、主要致病菌耐药性均有差异。Objective To understand the differences of ICU specimen sources,bacterial species and drug resistance rate in different attribute medical institutions by analyzing the epidemiological characteristics of clinical pathogenic bacteria in Intensive Care Unit(ICU)of public tertiary hospitals and private tertiary hospitals in Shaanxi Province.Methods The ICU data reported to the Shaanxi provincial bacterial drug resistance monitoring network from 49 public tertiary hospitals and 4 private tertiary hospitals in Shaanxi Province from January 2019 to December 2020 were retrospectively analyzed.The WHONET5.6 and SPSS22.0 software were adopted to conduct the data analysis for understanding whether there were differences in the source of specimens,bacterial species and drug resistance of main pathogenic bacteria in different types of tertiary hospitals.Results The specimens source of ICU from public tertiary hospitals and private tertiary hospitals was mainly the respiratory tract specimens.The proportion of sputum samples from ICU of public hospitals was much higher than that of private hospitals(P<0.05),but the proportion of bronchoalveolar lavage fluid was lower than that of private hospitals(P<0.05).Gram negative bacteria were the major pathogens detected in ICU of public tertiary hospitals and private tertiary hospitals,accounting for 78.3% and 79.3% respectively.The resistance rate of Klebsiella pneumoniae to carbapenems in ICU of private tertiary hospitals was higher than that of public tertiary hospitals(P<0.05).The resistance rates of Acinetobacter baumannii and Pseudomonas aeruginosa to carbapenems in ICU of public tertiary hospitals were higher than those of private tertiary hospitals(P<0.05).The resistance rates of Staphylococcus aureus to erythromycin and cefoxitin in ICU of public tertiary hospitals were higher than those of private tertiary hospitals(P<0.05).The resistance rates of Enterococcus faecium to high concentration of streptomycin and gentamicin in ICU of public tertiary hospitals were higher than tho

关 键 词：公立医院 民营医院 三级医院 重症监护室 病原菌特点 耐药性分析 

分 类 号：R372[医药卫生—病原生物学]