2012-2021年住院老年患者感染病原菌分布及耐药趋势  

Distribution and drug resistance changes of pathogenic bacteria in hospitalized elderly inpatients from 2012 to 2021

作　　者：刘娜 王娜娜[2] 纪冰[2] 丁雪梅 刘雅鑫 房晓庆 张晓丽[1] LIU Na;WANG Nana;JI Bing;DING Xuemei;LIU Yaxin;FANG Xiaoqing;ZHANG Xiaoli(Nursing College of Binzhou Medical University,Yantai 264003,Shandong,China;Laboratory Department,Affiliated Hospital of Binzhou Medical University,Binzhou 256603,Shandong,China)

机构地区：[1]滨州医学院护理学院,山东烟台264003 [2]滨州医学院附属医院检验科,山东滨州256603

出　　处：《山东大学学报（医学版）》2023年第6期29-40,46,共13页Journal of Shandong University:Health Sciences

基　　金：山东省重点研发计划(2018GSF118207)。

摘　　要：目的调查住院老年患者感染病原菌分布及其耐药性变化趋势,为临床合理用药提供参考依据。方法收集2012年1月至2021年12月滨州医学院附属医院住院老年患者感染的病原菌,选用Cochran-Armitage趋势检验分析主要病原菌耐药率的年变化趋势。结果10年间共分离12258株病原菌,革兰阴性菌占81.7%,最常见的是大肠埃希菌(19.7%);革兰阳性菌占18.3%,最常见的是金黄色葡萄球菌(5.7%)。22.5%的病原菌来自重症监护室,55.0%的病原菌分离自痰液标本。大肠埃希菌和肺炎克雷伯杆菌对碳青霉烯类抗菌药的耐药率在3%以下。10年间铜绿假单胞杆菌对碳青霉类抗菌药物的耐药率为10.2%~21.8%。鲍曼不动杆菌对碳青霉烯类抗菌药物的耐药率虽总体呈下降趋势,但2021年对其耐药率仍在40%以上。10年间耐甲氧西林金黄色葡萄球菌所占比为18.8%~44.7%,且期间检测到2株耐万古霉素的金黄色葡萄球菌和3株耐万古霉素的屎肠球菌。结论住院老年患者感染病原菌种类繁多且耐药形势不容乐观,医院应持续监测病原菌耐药情况,为临床合理应用抗菌药物提供科学依据。Objective To investigate the distribution of pathogenic bacteria and the trend of drug resistance in hospitalized elderly patients,so as to provide reference for rational clinical use of drugs.Methods Pathogenic bacteria were collected from Jan.2012 to Dec.2021 in elderly patients hospitalized in the Affiliated Hospital of Binzhou Medical University.The annual trend of drug resistance rate of major pathogenic bacteria was analyzed with Cochran-Armitage trend test.Results A total of 12258 pathogenic bacteria were isolated,of which Gram-negative bacteria accounted for 81.7%,and Escherichia coli(19.7%)was the most common;Gram-positive bacteria accounted for 18.3%,the most common being Staphylococcus aureus(5.7%).22.5%of the pathogenic bacteria were isolated from the intensive care unit and 55.0%from sputum specimens.Resistance rates to carbapenems in Escherichia coli and Klebsiella pneumoniae were below 3%.10.2%to 21.8%of Pseudomonas aeruginosa were resistant to carbapenems over a 10-year period.Although the resistance rate of Acinetobacter baumannii to carbapenems was generally declining,it was still above 40%in 2021.The detection rate of methicillin-resistant Staphylococcus aureus ranged from 18.8%to 44.7%over the 10-year period,and two vancomycin-resistant strains of Staphylococcus aureus and three vancomycin-resistant strains of Enterococcus faecalis were detected during this period.Conclusion It is recommended that hospitals should continuously monitor pathogenic bacteria for rational use of antibacterial drugs in clinic.

关 键 词：住院老年患者 病原菌 抗菌药物 耐药性 

分 类 号：R181[医药卫生—流行病学]