2016年至2020年老年患者尿标本分离细菌的耐药性变迁的研究  

Study on bacterial resistance surveillance from urine specimens of geriatric patients from 2016 to 2020

作　　者：赖蓓[1] 葛春悦 宋刚 艾效曼[2] LAI Bei;GE Chun-yue;SONG Gang;AI Xiao-man(HealthCare Department,BejingHospital,National Centerof Gerontology,In1stitute Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China;DepartmentofLaboratory Medicine,BejingHospital,National Centerof Gerontology,In1stitute Geriatric Medicine,Chinese Academy of Medical Science,Beijing 100730,China)

机构地区：[1]北京医院国家老年医学中心,中国医学科学院老年医学研究院保健医疗部,北京100730 [2]北京医院国家老年医学中心,中国医学科学院老年医学研究院检验科,北京100730

出　　处：《中国临床药理学杂志》2022年第24期3031-3035,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的 了解北京医院2016年至2020年老年患者尿标本分离细菌的分布及其对常用抗菌药物的耐药性,为老年尿路感染患者的经验性治疗提供参考。方法 收集本院2016年1月至2020年12月期间老年患者尿标本分离的细菌,采用自动化微生物分析仪或纸片扩散法进行临床菌株的药物敏感性试验,药敏结果判断参照2018年美国临床实验室标准化协会(CLSI)文件标准判断。WHONET软件对临床分离的主要病原菌进行耐药数据分析。结果 2016年至2020年尿标本分离的细菌中,排在前5位的主要为大肠埃希菌、屎肠球菌、粪肠球菌、肺炎克雷伯菌和铜绿假单胞菌。大肠埃希菌对三代头孢噻肟和喹诺酮类的耐药率分别为50.3%~65.2%和68.3%~77.0%,肺炎克雷伯菌的碳青霉烯类耐药率为32.4%~45.3%,屎肠球菌的万古霉素耐药率为9.6%~14.6%。结论 我院老年尿标本分离细菌中大肠埃希菌、屎肠球菌、粪肠球菌、肺炎克雷伯菌和铜绿假单胞菌为常见病原菌,对常用抗菌药物耐药率较高,应重视老年尿路感染病原学检测,根据耐药监测结果合理应用抗菌药物。Objective To investigate the susceptibility profile of clinical isolates from urine of geriatric patients in Beijing Hospital during 2016-2020. Methods Bacteria from urine specimens of geriatric patients were collected between Jan 2016 and Dec 2020. Bacterial susceptibility testing was carried out by means of an unified protocol using Kirby-Bauer method and MIC determination. The results were analyzed according to Clinical and Laboratory Standards Institute(CLSI) 2018 breakpoints. The data was analyzed by using WHONET software. Results Bacteria isolated from urine samples from 2016 to 2020,the most common species were Escherichia coli, Enterococcus faecium, Enterococcus faecalis, Klebsiella pneumoniae and Pseudomonas aeruginosa. The resistant rate of E. coli to cefotaxime and quinolone were 50.3%-65.2% and 68.3%-77.0%, respectively;the resistant of K. pneumoniae to carbapenem were 32.4%-45.3%, the resistant of E. faecium to vancomycin were 9.6%-14.6%. Conclusion E. coli, E. faecium, E. faecalis, K. pneumoniae and P. aeruginosa were still the most common pathogens in urinary tract infections, associated with higher antibiotic resistance among geriatric patients. More attention should be paid to the monitoring of pathogens in geriatric patients with urinary tract infection and rational use of antibiotics according to the surveillance of antimicrobial resistance.

关 键 词：老年患者 尿标本 抗菌药物 耐药性 病原菌 

分 类 号：R978.1[医药卫生—药品]