2020-2022年检验科微生物室多重耐药菌检测结果及检验质量的影响因素分析  

Analysis of the factors influencing the detection results and quality of multidrug resistant bacteria in the microbiology room of the clinical laboratory from 2020 to 2022

作　　者：王娜 范杰斐 王文茜 WANG Na;FAN Jiefei;WANG Wenqian(Xinriang Central Hospital/The fourth Clinical College of Xinriang Medical University,Xinriang 453000,Henan,China)

机构地区：[1]新乡市中心医院/新乡医学院第四临床学院,河南新乡453000

出　　处：《中国病原生物学杂志》2024年第9期1088-1091,共4页Journal of Pathogen Biology

摘　　要：目的探讨本院检验科微生物室多重耐药菌分布特点及检验质量的影响因素。方法选取本院2020-2022年检验科检验的482份微生物标本,进行菌种鉴定及药敏试验,分析多重耐药菌标本来源、科室分布、耐药性等特点,统计分析病原菌培养检测结果的准确率及影响检验质量的相关因素所占比例。结果482份微生物标本检出病原菌516株,多重耐药菌95株,检出率为18.41%。2020年多重耐药菌30株,检出率20.55%(30/146),2021年多重耐药菌42株,检出率24.28%(42/173),2022年多重耐药菌23株,检出率12.30%(23/187),不同年份多重耐药菌的检出率差异有统计学意义(χ^(2)=8.878,P<0.05)。95株多重耐药菌包括鲍曼不动杆菌30株,铜绿假单胞菌24株,金黄色葡萄球菌23株,肺炎克雷伯菌5株,大肠埃希菌5株,表皮葡萄球菌3株,肺炎链球菌2株,产酸克雷伯菌1株,产气肠杆菌1株,弗劳地氏枸橼酸杆菌1株。95株多重耐药菌主要来源于痰液标本、尿液标本、伤口分泌物标本。痰液标本、尿液标本、伤口分泌物标本的多重耐药菌检出率最高,分别为23.16%、15.79%和11.58%。95株多重耐药菌主要分布于重症医学科、康复医学科、呼吸内科,检出率分别为18.95%、11.58%和9.47%。金黄色葡萄球菌对青霉素类青霉素G,红霉素类红霉素、克林霉素,氨基糖苷类妥布霉素的耐药率为100%,未产生对多肽类抗生素替考拉宁、万古霉素,唑烷酮类利奈唑胺的耐药株。鲍曼不动杆菌与铜绿假单胞菌对氨基糖苷类庆大霉素的耐药率为100%,对四环素类米诺环素表现为较高的敏感性。482份微生物标本病原菌培养结果检验报告误差率为10.17%(49/482)。影响微生物检验质量的影响因素主要为:28份为标本质量因素,主要为患者自身生理因素;15份为检验操作因素,主要为检验流程不规范;6份为检验工作人员因素,主要为标本送检方式不当。结论本院多重耐药菌主要以鲍�Objective To explore the distribution characteristics of multidrug-resistant bacteria in the microbiology department of our hospital from 2020 to 2022 and the influencing factors on the quality of testing.Methods 482 microbial specimens tested by our laboratory from 2020 to 2022 were selected.The bacterial identification and drug sensitivity testing were performed,to analyze the sources,departmental distribution,and resistance characteristics of multidrug-resistant bacterial specimens.The accuracy of pathogen culture detection results and the proportion of relevant factors affecting test quality were analyzed statistically.Results A total of 516 pathogenic bacteria were detected from 482 microbial specimens,including 95 multidrug-resistant bacteria,with a detection rate of 18.41%.In 2020,there were 30 multidrug-resistant bacteria,with a detection rate of 20.55%(30/146).In 2021,there were 42 multidrug-resistant bacteria,with a detection rate of 24.28%(42/173).In 2022,there were 23 multidrug-resistant bacteria,with a detection rate of 12.30%(23/187).The differences in the detection rates of multidrug-resistant bacteria in different years were statistically significant(χ^(2)=8.878,P<0.05).95 strains of multidrug-resistant bacteria included 30 strains of Acinetobacter baumannii,24 strains of Pseudomonas aeruginosa,23 strains of Staphylococcus aureus,5 strains of Klebsiella pneumoniae,5 strains of Escherichia coli,3 strains of S.epidermidis,2 strains of S.pneumoniae,1 strain of K.acidogenes,1 strain of Enterobacter aerogenes,and 1 strain of Citrobacter freundii.The 95 strains of multidrug-resistant bacteria mainly came from sputum samples,urine samples,and wound secretion samples.The detection rates of multidrug-resistant bacteria in sputum samples,urine samples,and wound secretion samples were the highest,with detection rates of 23.16%,15.79%,and 11.58%,respectively.The 95 multidrug-resistant bacteria were mainly distributed in the Department of Critical Care Medicine,the Department of Rehabilitation Medicine,and th

关 键 词：多重耐药菌 耐药性 检验质量 

分 类 号：R446.5[医药卫生—诊断学]