河南某肿瘤医院临床分离菌分布及耐药性分析  

Distribution and Drug Resistance Analysis of Clinical Bacterial Isolates Collected from a Henan Tumor Hospital

作　　者：屈元晔 肖伟强 常彦敏 孙明月 王小昆 许青霞 QU Yuan-ye;XIAO Wei-qiang;CHANG Yan-min;SUN Ming-yue;WANG Xiao-kun;XU Qing-xia(Department of Clinical Laboratory,Affiliated Cancer Hospital of Zhengzhou University,Zhengzhou 450000,China)

机构地区：[1]郑州大学附属肿瘤医院检验科,郑州450000

出　　处：《中国合理用药探索》2024年第7期42-51,共10页Chinese Journal of Rational Drug Use

摘　　要：目的:分析河南某肿瘤医院临床分离菌的分布及耐药性,为临床合理用药提供依据。方法:采用WHONET 5.6软件,分析2019年1月~2021年12月期间该院临床分离的所有细菌分布情况及耐药性。结果:共收集非重复菌株14769株,其中革兰阴性菌9863株(66.8%),革兰阳性菌4906株(33.2%)。标本以呼吸道(4295株,29.1%)、无菌体液(4093株,27.7%)和血液(2576株,17.4%)为主,科室分布以血液科(3134株,21.2%)、胃肠外科(1737株,11.8%)、肝胆外科(1703株,11.5%)、骨科(956株,6.5%)和重症医学病房(ICU,808株,5.5%)为主。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)3年的检出率依次为35.5%(175/493)、36.4%(176/483)、41.2%(206/500)和78.8%(246/312)、65.6%(231/352)、61.7%(227/368)。屎肠球菌对多数抗菌药物的耐药率均高于粪肠球菌。大肠埃希菌对碳青霉烯类仍高度敏感,3年的耐药率均低于5.0%。肺炎克雷伯菌对亚胺培南和美罗培南3年的耐药率呈下降趋势。铜绿假单胞菌对大多数抗菌药物的耐药率均低于鲍曼不动杆菌。ICU和血液科多重耐药菌的检出率较高。结论:该院2019年1月~2021年12月期间肿瘤患者临床分离菌株以革兰阴性杆菌为主,多重耐药菌除MRSA和CRPA有所上升外,其他均呈下降趋势,应继续加强医院感染防控,重视细菌耐药监测。Objective:To analyze the distribution and drug resistance of clinical bacterial isolates in a Henan tumor hospital so as to provide the basis for clinical rational drug use.Methods:WHONET 5.6 software was used to analyze the distribution and drug resistance of all the bacterial isolates collected from a hospital during the period of January 2019 to December 2021.Results:A total of 14769 non-repetitive strains were collected,including 9863(66.8%)strains of Gram-negative bacterial and 4906(33.2%)strains of Gram-positive bacterial.The strains were mainly isolated from specimens of respiratory tract(4295 strains,29.1%),sterile body fluids(4093 strains,27.7%)and blood(2576 strains,17.4%),and primarily distributed in the hematology department(3134 strains,21.2%),gastrointestinal surgery(1737 strains,11.8%),hepatobiliary surgery(1703 strains,11.5%),orthopedics(956 strains,6.5%)and intensive care unit(ICU)(808 strains,5.5%).The detection rates in the three years for methicillin-resistant Staphylococcus aureus(MRSA)were 35.5%(175/493),36.4%(176/483),and 41.2%(206/500),respectively,and 78.8%(246/312),65.6%(231/352)and 61.7%(227/368)for methicillin-resistant coagulase-negative Staphylococci(MRCNS).Enterococcus faecium showed a higher resistance rate against most antibiotics as compared with Enterococcus faecalis.Escherichia coli was still highly sensitive to carbapenems,and the resistance rates in all three years were lower than 5.0%.The drug resistance rates of Klebsiella pneumoniae against imipenem and meropenem were declining over 3 years.The resistance rate of Pseudomonas aeruginosa against most antimicrobials was lower than that of Acinetobacter baumannii.The detection rate of multi-drug resistant bacterial in ICU and hematology department was higher.Conclusion:Gram-negative bacilli were the main isolates collected from tumor patients in the hospital from January 2019 to December 2021,and there was a decreasing trend in all multi-drug resistant bacterial with the exception of MRSA and CRPA which showed an increasing tr

关 键 词：细菌分布 肿瘤患者 耐药率 金黄色葡萄球菌 铜绿假单胞菌 

分 类 号：R446.5[医药卫生—诊断学]