2017-2021年某医院创伤中心住院患者样本检出病原菌及其耐药性  

Distribution and drug resistance of pathogens isolated from specimens of hospitalized patients trauma center of a hospital from 2017 to 2021

作　　者：李怡[1,2] 申家莹 王志翔[1] 陈琛 王南南 梁沛枫[3] 刘鹏[4] LI Yi;SHEN Jia-ying;WANG Zhi-xiang;CHEN Chen;WANG Nan-nan;LIANG Pei-feng;LIU Peng(People's Hospital of Ningxia Hui Autonomous Region,Yinchuan,Ningxia 75oo0l,China)

机构地区：[1]宁夏回族自治区人民医院医院感染管理科,宁夏银川750001 [2]宁夏回族自治区人民医院医院中心实验室,宁夏银川750001 [3]宁夏回族自治区人民医院医院病案统计科,宁夏银川750001 [4]宁夏回族自治区人民医院医院骨科中心,宁夏银川750001

出　　处：《中华医院感染学杂志》2023年第11期1617-1621,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81760608)。

摘　　要：目的了解某院创伤中心住院患者病原菌与耐药特性,为优化临床科室的抗菌药物治疗方案提供参考。方法收集2017年1月-2021年12月宁夏回族自治区人民医院创伤中心住院患者临床检出病原菌,采用VITEK-2全自动微生物鉴定系统进行菌株鉴定,采用纸片扩散(K-B)法测定细菌药物敏感性,对病原菌的临床分布和耐药特性进行分析。结果2017-2021年度创伤中心住院患者共分离病原菌4199株,其中革兰阴性菌2456株占58.49%,以阴沟肠杆菌、大肠埃希菌和铜绿假单胞菌为主;革兰阳性菌1652株占39.34%,以金黄色葡萄球菌、粪肠球菌和屎肠球菌为主;标本以伤口分泌物及脓液标本为主,共检出2132株占50.77%;坏死组织标本次之共检出840株占20.00%;阴沟肠杆菌对头孢西丁耐药率最高为91.61%,对美罗培南耐药率最低为0.45%;金黄色葡萄球菌对青霉素耐药率最高为98.75%,未检出对万古霉素、替加环素、利奈唑胺耐药的菌株。结论该院创伤中心住院患者病原菌检出主要为革兰阴性菌,主要的检出病原菌种类为金黄色葡萄球菌和阴沟肠杆菌,应优化临床抗菌药物治疗方案,同时加强对诊疗环境的清洁消毒,减少病原菌在医疗环境的定植,降低交叉感染风险。OBJECTIVE To understand the pathogenic bacteria and drug resistance characteristics of patients hospitalized in a trauma center of a hospital,so as to provide reference for optimizing the antimicrobial drug treatment plan in clinical departments.METHODS The pathogenic bacteria detected in the inpatients clinic of the trauma center of People's Hospital of Ningxia Hui Autonomous Region from 2017 to 2021 were collected,and the strains were identified using the VITEK-2 automatic microbial identification system,the bacteria drug susceptibility was determined using the disc diffusion method(K-B method),and the clinical distribution and drug resistance characteristics of the pathogenic bacteria were analyzed.RESULTS A total of 4199 pathogenic bacteria were isolated from inpatients in the trauma center from 2017 to 2021,of which 2456 stains of Gram-negative bacteria accounted for 58.49%,dominated by Enterobacter cloacae,Escherichia coli and Pseudomonas aeruginosa;1652 strains of Gram-positive bacteria accounted for 39.34%,dominated by Staphylococcus aureus,Enterococcus faecalis and Enterococcus faecium.The specimens were mainly wound secretions and pus,and a total of 2132 strains were detected,accounting for 50.77%;followed by necrotic tissue specimens,with a total of 840 strains detected,accounting for 20.00%;The highest resistance rate to cefoxitin was 91.61%and the lowest resistance rate to meropenem was 0.45%for Enterobacter cloacae;the highest resistance rate to penicillin was 98.75%for Staphylococcus aureus,and no strains resistant to vancomycin,tigecycline and linezolid were detected.CONCLUSION The pathogenic bacteria detected in the inpatients in the trauma center of this hospital were mainly Gram-negative bacteria,and the main pathogenic bacteria detected were Staphylococcus aureus and Enterobacter cloacae.The clinical antimicrobial treatment plan should be optimized and the cleaning and disinfection of the treatment environment should be strengthened to reduce the colonization of pathogenic bacteria in the medi

关 键 词：创伤中心 住院患者 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]