某三甲医院重症医学科2019至2020年送检标本病原菌分布及耐药性分析  

Analysis of pathogen distribution and drug resistance of clinical specimens in department of critical care medicine of a comprehensive tertiary-level hospital from 2019 to 2020

作　　者：谢璐璐 刘贤 刘博 沈锋 王迪芬 Xie Lulu;Liu Xian;Liu Bo;Shen Feng;Wang Difen(Department of Critical Care Medicine,the Affiliated Hospital of Guizhou Medical University,Guiyang 550004,Guizhou,China)

机构地区：[1]贵州医科大学附属医院重症医学科,贵州贵阳550004

出　　处：《中国中西医结合急救杂志》2022年第3期279-283,共5页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：国家重点研发计划(2018YFC2001900)。

摘　　要：目的 分析重症医学科感染病原菌分布及耐药情况,为临床重症感染患者抗感染治疗提供部分依据.方法 收集2019年1月至2020年12月贵州医科大学附属医院重症医学科住院患者送检标本,对各年度送检标本类型、数量进行统计;采用全自动微生物鉴定及药敏测试仪器对分离的病原菌进行鉴定和药敏试验,分析各年度阳性标本病原菌分布及其耐药性.结果 2019年送检标本13215份,2020年送检11880份,A、B、C 3个病区在2019年检出革兰阳性(G+)菌分别为122、140、107株,革兰阴性(G-)菌分别为479、481、401株,假丝酵母菌分别为70、62、55株;2020年检出G+菌分别为106、102、75株,G-菌分别为633、454、396株,假丝酵母菌分别为87、42、64株.2019年鲍曼不动杆菌检出率最高,其次为肺炎克雷伯菌、大肠埃希菌.2020年检出阳性前3位的细菌为肺炎克雷伯菌、鲍曼不动杆菌和铜绿假单胞菌.鲍曼不动菌、肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌对头孢类抗菌药物普遍存在耐药性,尤其以鲍曼不动杆菌表现为高耐药率,其对美罗培南和亚胺培南的耐药性逐年上升.结论 感染在重症监护病房(ICU)普遍存在,G-菌仍是常见感染病原菌,鲍曼不动杆菌是肺部感染最常见病原菌,多重耐药鲍曼不动杆菌在感染病原菌中占比较高.Objective To analyze the distribution of infectious pathogens and drug resistance in the department of critical care medicine and provide a partial basis for clinical anti-infective treatment of patients with severe infection.Methods The specimens submitted by hospitalized patients in the department of critical care medicine of the Affiliated Hospital of Guizhou Medical University from January 2019 to December 2020 were collected,and the types and quantities of specimens submited for inspection in each year were counted.The isolated pathogenic bacteria were identified and tested for drug susceptibilty by using full-automatic microbial identification and drug susceptibility testing instruments,and the distribution and drug resistance of pathogenic bacteria in positive samples in each year were analyzed.Results In 2019,13215 specimens were submitted for inspection,and in 2020,11880 were submitted for inspection.In 2019,in 3 wards A,B,and C,122,140,107 strains of Gram-positive(G')bacteria were detected out,respectively,Gram-negative(G)bacteria were 479,481,and 401 strains found,respectively,and Candida bacteria were 70,62,and 55 strains seen,respectively.In 2020,in above 3 wards,106,102,and 75 strains of G*bacteria were detected,633,454,and 396 strains of G-bacteria were found,and 87,42,and 64 strains of Candida bacteria were seen.In 2019,the detection rate of Acinetobacter baumanni was the highest,followed by Klebsiella pneumoniae and Escherichia coli.The top three bacteria with high positive detection rate in 2020 were Klebsiela pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa.Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli were generally resistant to cephalosporins,especially Acinetobacter baumanni showed a high resistance rate,and its resistance to meropenem and imipenem is increasing year by year.Conclusion Infections are prevalent in the intensive care unit(ICU),G'bacteria are still the common pathogens of infection,Acinetobacter baumanni is the most commo

关 键 词：重症医学科 重症感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]