2010—2020年河南省某三甲医院临床病原菌分布及耐药性分析  

Distribution and drug resistance of clinical pathogens in a tertiary hospital in Henan Province from 2010 to 2020

作　　者：刘克锋[1,3] 孟海阳 孟宪春 徐璐[5] 张瑞 刘宇 张晓坚[1,3] 牛进波[6] 徐岷[2,4] LIU Ke-feng;MENG Hai-yang;MENG Xian-chun;XU Lu;ZHANG Rui;LIU Yu;ZHANG Xiao-jian;NIU Jin-bo;XU Min(Department of Pharmacy,The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Laboratory,The First Affliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Henan Drug Clinical Comprehensive Evaluation Center,Zhengzhou 450052,Henan Province,China;Key Laboratory of Laboratory Medicine of Henan Province,Zhengzhou 450052,Henan Province,China;Department of Laboratory,Henan Children's Hospital,Zhengzhou 450052,Henan Province,China;Department of Pharmacy,The Third Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China)

机构地区：[1]郑州大学第一附属医院药学部,河南郑州450052 [2]郑州大学第一附属医院检验科,河南郑州450052 [3]河南省药品临床综合评价中心,河南郑州450052 [4]河南省临床检验重点实验室,河南郑州450052 [5]河南省儿童医院检验科,河南郑州450052 [6]郑州大学第三附属医院药学部,河南郑州450052

出　　处：《中国临床药理学杂志》2023年第14期2084-2088,共5页The Chinese Journal of Clinical Pharmacology

摘　　要：目的探讨2010—2020年河南省某三甲医院临床病原菌的分布情况及耐药性,为医院感染的防控及临床合理使用抗菌药物提供参考。方法收集2010年1月至2020年12月医院临床分离病原菌分布及耐药性相关数据,根据美国临床和实验室标准化协会标准判读药敏结果,用WHONET 5.6软件进行数据分析。结果2010—2020年共收集细菌总数为166776株,其中革兰氏阴性菌113284株(67.93%),革兰氏阳性菌53492株(32.07%)。排名前5位的分别是大肠埃希菌30456株(18.26%),肺炎克雷伯菌22643株(13.58%),铜绿假单胞菌17477(10.48%),鲍曼不动杆菌17157(10.29%),金黄色葡萄球菌14687(8.81%)。金黄色葡萄球菌对青霉素平均耐药率达96.10%(95.60%~96.60%),几乎未检测出耐万古霉素的金黄色葡萄球菌,利奈唑胺的耐药率小于1.0%。2010-2020年大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌、鲍曼不动杆菌对亚胺培南和美罗培南的平均耐药率分别是1.88%(0.50%~3.50%)、24.29%(1.60%~48.60%)、25.20%(21.80%~25.90%)、84.27%(70.20%~92.50%),尤其是肺炎克雷伯菌的耐药率逐年上升。结论细菌耐药情况日趋严重,其中肺炎克雷伯菌、鲍曼不动杆菌对碳青霉烯类的耐药率持续上升,为临床抗感染治疗带来很大挑战,医院临床应高度重视,加强防控措施和抗菌药物的合理使用,做好细菌的耐药监测,保障医疗安全。Objective To investigate the distribution and drug resistance of clinical pathogens in a tertiary hospital in Henan Province from 2010 to 2020,so as to provide reference for the prevention and control of nosocomial infection and the rational use of antibiotics in clinical practice.Methods The distribution and drug resistance data of clinical isolates of pathogens in hospitals from January 2010 to December 2020 were collected,and the drug susceptibility results were interpreted according to the standards of the American Clinical and Laboratory Standard Institute,and WHONET 5.6 software was used for data analysis.Results A total of 166776 bacterial strains were collected from 2010 to 2020,including 113284(67.93%)Gram-negative bacteria and 53492(32.07%)Gram-positive bacteria.The top five were Escherichia coli 30456 strains(18.26%),Klebsiella pneumoniae 22643 strains(13.58%),Pseudomonas aeruginosa 17477(10.48%)Acinetobacter baumannii 17157(10.29%),and Staphylococcus aureus 14687(8.81%).The average resistance rate of Staphylococcus aureus to penicillin was 96.10%(95.60%~96.60%).Almost no Staphylococcus aureus resistant to vancomycin was detected,and the resistance rate of linezolid was less than 1.0%.From 2010 to 2020,the average resistance rates of Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Acinetobacter baumannii to imipenem and meropenem were 1.88%(0.50%-3.50%),24.29%(1.60%-48.60%),25.20%(21.80%-25.90%),84.27%(70.20%-92.50%),respectively.The resistance rate of Klebsiella pneumoniae increased year by year.Conclusion The drug resistance of bacteria is becoming more and more serious.The drug resistance rates of Klebsiella pneumoniae and Acinetobacter baumannii to carbapenems continue to rise,which bring great challenges to clinical anti-infective treatment.Hospitals should attach great importance to clinic practice,strengthen prevention and control measures and the rational use of antibiotics,monitor bacterial resistance,and ensure medical safety.

关 键 词：抗菌药物 临床分离菌 耐药率 多重耐药菌 

分 类 号：R978.1[医药卫生—药品]