2018—2020年广州地区重症监护病房病原菌分布特征及耐药性分析  

Distribution characteristics and drug resistance analysis of pathogens in intensive care units in Guangzhou,2018-2020

作　　者：张汉运 洪威 卓惠燕 ZHANG Hanyun;HONG Wei;ZHUO Huiyan(Liwan District Center for Disease Control and Prevention,Guangzhou 510176,China;Zhuhai Maternal and Child Health Hospital;He Xian Memorial Hospital of Panyu District)

机构地区：[1]广州市荔湾区疾病预防控制中心,广东广州510176 [2]珠海市妇幼保健院 [3]广州市番禺区何贤纪念医院

出　　处：《华南预防医学》2023年第5期573-577,582,共6页South China Journal of Preventive Medicine

基　　金：广州市番禺区科技计划项目(2021-Z04-046)。

摘　　要：目的了解2018—2020年广州市某医院重症监护病房(intensive care unit,ICU)患者病原菌分布情况及耐药趋势,为制定合理的感染控制措施提供有力依据。方法收集2018—2020年广州市某医院ICU患者检出的病原菌和药敏结果,采用描述性分析方法对结果进行分析。结果2018—2020年从7164份送检样本中检出1978株非重复菌株,以革兰阴性菌为主,3年分别为338(61.0%)、439(57.2%)、387(59.0%)株。鲍曼不动杆菌对大多数抗菌药物维持较高的耐药率(>33.3%),大肠埃希菌对碳青霉烯类药物保持良好的敏感性(≤4.8%),而铜绿假单胞菌却相反(>27.6%)。耐甲氧西林金黄色葡萄球菌和碳青霉烯类耐药肠杆菌科细菌耐药率有上升趋势(均P<0.01)。结论加强监测ICU患者病原菌分布情况及耐药趋势,严格执行手卫生、环境清洁和器械消毒、加强重点抗菌药物合理应用的监管等控制措施,可有效预防多重耐药菌的产生及交叉传播。Objective To know the distribution and drug resistance trend of pathogens in intensive care unit(ICU)patients of a hospital in Guangzhou from 2018 to 2020,and provide a strong basis for formulating reasonable infection control measures.Methods The results of pathogens and drug susceptibility detected from ICU patients in a hospital in Guangzhou from 2018 to 2020 were collected,and the data were statistically analyzed using software WHONET 5.6 and SPSS 25.Results From 2018 to 2020,a totally 1978 strains of non-repeating pathogens were isolated from 7164 samples,mainly Gram-negative bacteria,338(61.0%),439(57.2%),and 387(59.0%)strains each year respectively.Acinetobacter baumannii maintained a high resistance rate to most antibiotics(>33.3%),Escherichia coli maintained a good sensitivity to carbapenems(≤4.8%),while Pseudomonas aeruginosa maintained the opposite(>27.6%).The drug resistance of Methicillin-resistant staphylococcus aureus and carbapenem-resistant Enterobacteriaceae had an upward trend(both P<0.01).Conclusion To effectively prevent the emergence and cross-transmission of multi-drug resistant organisms,we should strengthen the monitoring of the distribution of pathogens and the trend of drug resistance in ICU patients,strictly implement the control measures such as hand hygiene,environmental cleaning and instrument disinfection,and strengthen the supervision of the rational use of key antibacterial drugs.

关 键 词：重症监护病房 耐药性 多重耐药菌 

分 类 号：R117[医药卫生—公共卫生与预防医学]