某三甲医院两年内革兰阴性杆菌耐药性变化的研究  

Study on the change of Gram negative bacteria resistance in a third class hospital within two years

作　　者：张培[1] 林康[1] 李薇[1] 蔺昕[1] ZHANG Pei;LIN Kang;LI Wei;LIN Xin(Department of Clinical Laboratory,Nanjing Medical University Affiliated Nanjing Hospital(Nanjing First Hospital),Nanjing,Jiangsu 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)医学检验科,江苏南京210006

出　　处：《国际检验医学杂志》2023年第S02期77-82,共6页International Journal of Laboratory Medicine

基　　金：江苏省医学重点学科建设单位(JSDW202239)。

摘　　要：目的回顾性分析某三甲医院2020-2022年期间临床分离菌株的分布和耐药特征,为指导医疗合理应用抗菌药物提供可靠依据。方法分析调查期间医院住院患者培养呈阳性的所有菌株分布特点,针对主要的革兰阴性杆菌的分布和耐药性变化进行相关性分析。结果剔除重复后对共计9287株菌株分析统计,其中革兰阴性菌5627株(60.6%),革兰阳性菌2189株(23.6%),其余为真菌1471株(15.8%)。最多见的多重耐药菌是碳青霉烯耐药鲍曼不动杆菌(CRAB)、碳青霉烯耐药肺炎克雷伯菌(CRKPN)和碳青霉烯耐药铜绿假单胞菌(CRPA)。经对比发现细菌对多数常规抗菌药的耐药率降低,也出现少数对多黏菌素类耐药的细菌。结论该医院多重耐药菌以革兰阴性杆菌为主,各种管控措施下细菌的耐药率降低,多黏菌素类抗菌药物耐药的出现需引起临床科室和管控部门的高度重视。Objective To retrospectively analyze the distribution and drug resistance characteristics of clinical isolates in a tertiary hospital from 2020 to 2021,and provide reliable basis for guiding the rational use of antibiotics in medical care.Methods A retrospective analysis was conducted on the distribution characteristics of all positive strains cultured in hospitalized patients of the tertiary hospital from January 2021 to December 2021.A correlation analysis was conducted on the distribution and drug resistance of the main Gram negative bacteria.Results After eliminating duplicates,a total of 9,287 strains were identified,including 5627 Gram negative bacteria(60.6%),2189 Gram positive bacteria(23.6%),and 1471 fungal strains(15.8%).The most common multidrug resistant bacteria were Carbapenem resistant Acinetobacter baumannii(CRAB),Carbapenem resistant Klebsiella pneumoniae(CRKPN),and Carbapenem resistant Pseudomonas aeruginosa(CRPA).After comparison,it was found that the resistance rate of bacteria to most conventional antibiotics was reduced,and a small number of bacteria resistant to Polymyxin were also found.Conclusion Gram negative bacteria are the main multi drug resistant strains in this hospital,and the drug resistance rate of bacteria is reduced under various control measures.The emergence of Polymyxin antibiotic resistance needs to be highly valued by clinical departments and control departments.

关 键 词：革兰阴性杆菌分布 耐药率 多重耐药菌 

分 类 号：R446.5[医药卫生—诊断学]