2020—2022年某院呼吸机相关性肺炎病原菌分布特征及耐药性变迁  

Distribution Characteristics and Drug Resistance Changes of Pathogenic Bacteria in Ventilator-associated Pneumonia in A Hospital from 2020 to 2022

作　　者：刘瑞英 陈锐 LIU Ruiying;CHEN Rui(Department of Emergency,Yingtan City People's Hospital,Yingtan 335000,China)

机构地区：[1]鹰潭市人民医院急诊科,江西鹰潭335000

出　　处：《中国医学创新》2024年第24期170-175,共6页Medical Innovation of China

摘　　要：目的:探究2020—2022年鹰潭市人民医院呼吸机相关性肺炎病原菌分布特征及耐药性变迁。方法:选取本院2020年1月—2022年12月收治的80例呼吸机相关性肺炎患者的病历资料进行回顾性分析。所有患者均于入院24 h内采集痰样本进行病原学培养及药敏试验,分析病原菌分布特征并对3年内主要感染病原菌的耐药率变化进行分析。结果:80例痰标本中共检出病原菌126株,其中革兰阴性菌96株(76.19%)、革兰阳性菌22株(17.46%)、真菌8株(6.35%),鲍曼不动杆菌(29.37%)、肺炎克雷伯菌(19.05%)、铜绿假单胞菌(17.46%)占比较高。鲍曼不动杆菌耐药性分析结果显示,鲍曼不动杆菌对氨曲南、头孢替坦的耐药性较高,对复方新诺明的耐药性较低;不同年份鲍曼不动杆菌各抗生素耐药率比较,差异均无统计学意义(P>0.05)。肺炎克雷伯菌耐药性分析结果显示,肺炎克雷伯菌对头孢哌酮舒巴坦钠、氨曲南的耐药性较高,各年份均≥50.00%,对阿米卡星、左氧氟沙星的耐药性较低,各年份均<15.00%;2020—2022年肺炎克雷伯菌对氨曲南的耐药率呈升高趋势,差异有统计学意义(P<0.05)。铜绿假单胞菌耐药性分析结果显示,铜绿假单胞菌对头孢替坦、亚胺培南、左氧氟沙星的耐药性较高,对哌拉西林钠他唑巴坦钠、复方新诺明的耐药性较低。不同年份铜绿假单胞菌各抗生素耐药率比较,差异均无统计学意义(P>0.05)。结论:呼吸机相关性肺炎病原菌分布中以鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌等革兰阴性菌为主,对多种抗菌药均存在不同程度的耐药,且肺炎克雷伯菌对氨曲南的耐药率表现出升高趋势。Objective:To explore the distribution characteristics and drug resistance changes of pathogenic bacteria in ventilator-associated pneumonia in Yingtan City People's Hospital from 2020 to 2022.Method:The medical records of 80 patients with ventilator-associated pneumonia admitted to our hospital from January 2020 to December 2022 were retrospectively analyzed.Sputum samples of all patients were collected within 24 h of admission for etiological culture and drug susceptible test.The distribution characteristics of pathogenic bacteria and the change of drug resistance rate of major pathogenic bacteria in 3 years were analyzed.Result:A total of 126 strains of pathogenic bacteria were detected in 80 sputum samples,including 96 strains(76.19%)of Gram negative bacteria,22 strains(17.46%)of Gram positive bacteria and 8 strains(6.35%)of fungus.Acinetobacter baumanii(29.37%),Klebsiella pneumoniae(19.05%),Pseudomonas aeruginosa(17.46%)accounted for the higher proportion.The drug resistance analysis of Acinetobacter baumanii showed that the resistance of Acinetobacter baumanii to Aztreonam and Cefotetan were higher,and the resistance of Compound Sulfamethoxazole was lower.There were no significant differences in resistance rates of each antibiotic of Acinetobacter baumanii in different years(P>0.05).The drug resistance analysis of Klebsiella pneumoniae showed that the drug resistance of Klebsiella pneumoniae to Cefoperazone Sulbactam Sodium and Aztreonam were higher,≥50.00%in each year,and the resistance of Aztreonam and Levofloxacin were lower,<15.00%in each year.The resistance rates of Klebsiella pneumoniae to Aztreonam showed an increasing trend from 2020 to 2022,the difference was statistically significant(P<0.05).The drug resistance analysis of Pseudomonas aeruginosa showed that the drug resistance of Pseudomonas aeruginosa to Cefotetan,Imipenem and Levofloxacin were higher,and the resistance of Piperacillin Sodium Tazobactam Sodium and Compound Sulfamethoxazole were lower.There were no significant differences in resi

关 键 词：呼吸机相关性肺炎 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学] R563.1[医药卫生—临床医学]