2018~2023年某心血管病医院临床痰标本中常见菌的分布与耐药性分析  

An Analysis of Distribution and Drug Resistance of Common Bacteria in Clinical Sputum Samples from a Cardiovascular Hospital During the Period 2018-2023

作　　者：曹晓静 周玉[1] 龚美亮[1] 王坤[1] 郑青 梁秀梅 焦姣[1] 邓新立[1] CAO Xiaojing;ZHOU Yu;GONG Meiliang;WANG Kun;ZHENG Qing;LIANG Xiumei;JIAO Jiao;DENG Xinli(Department of Clinical Laboratory,the Second Medical Center of PLA General Hospital,National Research Center for Geriatric Diseases,Beijing 100853,China;Community Health Service Center,Guangfu Street,Hebei District,Tianjin 100000,China)

机构地区：[1]解放军总医院第二医学中心检验科,国家老年疾病研究中心,北京100853 [2]天津市河北区光复道街社区卫生服务中心,天津300000

出　　处：《标记免疫分析与临床》2024年第8期1378-1381,1406,共5页Labeled Immunoassays and Clinical Medicine

基　　金：北京市自然科学基金资助项目(编号:L234052)。

摘　　要：背景随着临床广谱抗生素的应用,细菌的耐药性呈逐渐上升趋势,耐药类型和耐药机制越来越复杂。目的分析国内某心血管病医院痰标本中细菌的分布和耐药情况,拟更好地指导临床。方法收集天津泰达国际心血管病医院2018年1月1日至2023年10月31日来本院就诊患者的痰标本分离得到的细菌鉴定和药敏结果,用WHONET 5.4软件进行数据分析。结果6年时间从痰标本中共分离菌株3970株,其中革兰阴性杆菌(G-)2966株(74.71%),主要有肺炎克雷伯菌肺炎亚种1187株(29.90%)、铜绿假单胞菌株434株(10.93%)和鲍曼不动杆菌367株(9.24%);革兰阳性球菌(G+)572株(14.41%),主要为金黄色葡萄球菌329株(8.29%)、肺炎链球菌243株(6.12%)和真菌为白色念珠菌432株(10.88%)。革兰阴性菌对氨苄西林的耐药率均特别高,对其他抗生素的耐药率呈不同程度的上升趋势。未发现耐万古霉素的金黄色葡萄球菌和肺炎链球菌,金黄色葡萄球菌金黄亚种耐青霉素G,耐药性达90.9%,肺炎链球菌对复方新诺明和四环素的耐药高于50%。结论细菌菌谱的分析和耐药性的监测能够很好地了解细菌的分布动态和耐药性变迁,感染的球菌中主要是以金黄色葡萄球菌亚种和肺炎链球菌为主要的致病菌,肺炎克雷伯菌亚种及铜绿假单胞菌等对抗生素的耐药性非常高,本研究不仅为临床医生合理准确地使用抗生素提供依据,也对防治工作具有指导作用。Background The utilization of clinical broad-spectrum antibiotics has led to a gradual increase in bacterial drug resistance,accompanied by the emergence of increasing complexity of types and mechanisms of resistance.Objective This study aimed to analyze the distribution and drug resistance patterns of bacteria in sputum samples obtained from a cardiovascular hospital in China,with the objective of providing enhanced guidance for clinical practice.Methods Sputum samples collected from patients at Tianjin Taida International Cardiovascular Hospital between January 1,2018 and October 31,2023 were subjected to bacterial identification and drug sensitivity testing.The obtained data was analyzed using WHONET5.4 software.Results Over a period of six years,3970 strains were isolated from sputum samples,with Gram-negative bacilli(G-)accounting for the majority of 74.71%(2966 strains),followed by Klebsiella pneumoniae subspecies of 29.90%(1187 strains),Pseudomonas aeruginosa of 10.93%(434 strains)and Acinetobacter Pbaumannii of 9.24%(367 strains).Gram-positive cocci(G+)accounted for 14.41%of the total isolates,with Staphylococcus aureus being the most prevalent species of 8.29%(329 isolates),followed by Streptococcus pneumoniae of 6.12%(243 isolates)and Candida albicans of 10.88%.The resistance rate of ampicillin in Gram-negative bacteria was notably high,while the resistance rates to other antibiotics exhibited an increasing pattern with various degrees.No vancomycin-resistant strains of Staphylococcus aureus or Streptococcus pneumoniae were detected.The subspecies of Staphylococcus aureus exhibited a high level of resistance(90.9%)to penicillin G.Additionally,more than 50%of the tested strains of Streptococcus pneumoniae demonstrated resistance to cotrimoxazole and tetracycline.Conclusion The analysis of bacterial spectrum and drug resistance monitoring enables a comprehensive understanding of the distribution dynamics and changes in antibiotic resistance among bacteria.Staphylococcus aureus and Streptococcus pneumoniae

关 键 词：痰标本 细菌分布 耐药性分析 

分 类 号：R378[医药卫生—病原生物学]