2019-2022年新疆某三甲医院住院患者10080株下呼吸道感染病原菌种类及耐药性变迁  

Etiological agents and antimicrobial resistance patterns in lower respiratory tract infections among impatients of a tertiary hospital in Xinjiang

作　　者：芦永华 史发林 段玮[3] 张红梅[3] 黄芳 何文英 LU Yonghua;SHI Falin;DUAN Wei;ZHANG Hongmei;HUANG Fang;HE Wenying(Infection Management Department of the First Affiliated Hospital of Shihezi University,Shihezi,Xinjiang 832008,China;Public Health Department of Gansu Wuwei Cancer Hospital;Laboratory Department of the First Affiliated Hospital of Shihezi University)

机构地区：[1]石河子大学第一附属医院医院感染管理科,新疆石河子832008 [2]甘肃省武威肿瘤医院公共卫生科 [3]石河子大学第一附属医院检验科

出　　处：《现代疾病预防控制》2024年第6期442-449,共8页MODERN DISEASE CONTROL AND PREVENTION

基　　金：新疆维吾尔自治区重大科技专项项目(2020A03004-3);石河子大学第一附属医院管理基金(GL202101)。

摘　　要：目的了解住院患者下呼吸道感染病原菌分布特征及耐药性变化情况,为指导临床合理用药提供依据。方法回顾性收集2019—2022年新疆某三甲医院住院患者痰标本中分离的病原菌株数及对临床常用抗菌药物的药敏资料,分析病原菌的种类及对临床常用抗菌药物的耐药情况。结果2019—2022年下呼吸道感染痰标本共检出病原菌10080株,居前3位的依次为肺炎克雷伯菌2579株(25.59%)、鲍曼不动杆菌2250株(22.32%)和铜绿假单胞菌1828株(18.13%)。下呼吸道感染痰标本中分离出的病原菌对临床常用的抗菌药物包括亚胺培南、美罗培南、阿米卡星、妥布霉素的耐药率呈现上升趋势(P均<0.05),对哌拉西林、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢呋辛、头孢曲松、氨曲南、替加环素的耐药率呈现下降趋势(P均<0.05);未发现对万古霉素和利奈唑胺耐药的金黄色葡萄球菌。结论下呼吸道感染病原菌的耐药形势严峻,应加强抗菌药物使用的监测与管理,防止耐药情况进一步加重。Objective To assess the etiological agents and the trends in antibiotic resistance in lower respiratory tract infections among hospitalized patients,and to provide evidence to guide the rational clinical use of antibiotics.Methods A retrospective analysis was conducted on pathogenic strains isolated from sputum samples and their drug susceptibility to common antibiotics from hospitalized patients in our hospital from 2019 to 2022.Results Over the study period,10080 strains of bacteria were isolated in sputum samples of hospitalized lower respiratory tract infection inpatients.The most prevalent pathogens were 2579 Klebsiella pneumoniae(25.59%),2250 Acinetobacter baumannii(22.32%),and 1828 Pseudomonas aeruginosa(18.13%).Resistance to commonly used antibiotics,including imipenem,meropenem,amikacin,and tobramycin,showed an increasing trend(all P<0.05),while resistance to piperacillin,ampicillin/sulbactam,piperacillin/tazobactam,cefoperazone/sulbactam,cefuroxime,ceftriaxone,amtrexone,and tigecycline demonstrated a decreasing trend(all P<0.05).No instances of Staphylococcus aureus resistantance to vancomycin or linezolid was observed.Conclusions The resistance to commonly used antibiotics in the hospital is significant,necessitating enhanced monitoring and management of antibiotic use to prevent further exacerbation of antibiotic resistance.

关 键 词：下呼吸道感染 抗菌药物 肺炎克雷伯菌 鲍曼不动杆菌 铜绿假单胞菌 

分 类 号：R446.5[医药卫生—诊断学]