某医院重症医学科2020—2022年住院患者病原学及耐药情况分析  

Analysis on etiology and drug resistance of hospitalized patients in intensive care unit of a hospital from 2020 to 2022

作　　者：汤湖波 陈静 左小淑[1,3] Tang Hubo;Chen Jing;Zuo Xiaoshu(Department of Critical Care Medicine,Wufeng Tujia Autonomous County People's Hospital,Yichang 443413,Hubei,China;Department of Emergency,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China;Department of Critical Care Medicine,Renmin Hospital of Wuhan University,Wuhan 430060,Hubei,China)

机构地区：[1]五峰土家族自治县人民医院重症医学科,湖北宜昌443413 [2]武汉大学人民医院急诊科,湖北武汉430060 [3]武汉大学人民医院重症医学科,湖北武汉430060

出　　处：《实用检验医师杂志》2024年第3期201-205,共5页Chinese Journal of Clinical Pathologist

基　　金：中央高校基本科研业务费专项资金(2042022kf1096)。

摘　　要：目的分析某医院2020—2022年重症医学科(ICU)住院患者主要病原菌分布及耐药情况。方法回顾并分析2020年1月—2022年12月五峰土家族自治县人民医院ICU送检标本的细菌鉴定和药敏试验结果,分析主要病原菌构成及耐药情况。结果2020—2022年ICU送检标本共检出非重复临床分离株262株,其中肺炎克雷伯菌占比最高(54株,占20.61%),其次分别为大肠埃希菌35株(占13.36%),金黄色葡萄球菌26株(占10.00%),铜绿假单胞菌19株(占7.25%),流感嗜血杆菌15株(占5.73%),鲍曼不动杆菌13株(占4.96%),其他70株(占26.72%)。肺炎克雷伯菌对碳青霉烯类药物的耐药率为13.33%,对头孢菌素类和氨基糖苷类的耐药率为15%~20%,而对喹诺酮类的耐药率为13.64%;大肠埃希菌对头孢菌素类药物的耐药率为30%~50%,对氨基糖苷类的耐药率为10%~30%,对喹诺酮类的耐药率为37.93%;铜绿假单胞菌对头孢他啶的耐药率高达80.00%,对哌拉西林及哌拉西林/他唑巴坦的耐药率为10%~20%,对亚胺培南及美罗培南的耐药率分别为13.33%、20.00%;流感嗜血杆菌对哌拉西林的耐药率高达13.33%;鲍曼不动杆菌对碳青霉烯类药物的耐药率为81.82%。此外,金黄色葡萄球菌对青霉素的耐药率为100.00%,对苯唑西林的耐药率为21.70%。结论ICU分离出的细菌仍以革兰阴性(G^(-))菌为主,尤其是肺炎克雷伯菌和大肠埃希菌,面临的耐药形势较严峻,定期监测ICU主要病原菌的构成及其耐药谱的变化对于指导合理使用抗菌药物具有重要意义。Objective To analyze the distribution and drug resistance of major pathogens among hospitalized patients in intensive care unit(ICU)from January 2020 to December 2022.Methods A retrospective analysis was conducted on bacteria identification and drug sensitivity results of specimens submitted to ICU of Wufeng Tujia Autonomous County People's Hospital.The composition and drug resistance of the main pathogens were analyzed.Results From 2020 to 2022,a total of 262 non duplicated clinical isolates were detected from ICU specimens.Among them,Klebsiella pneumoniae had the highest proportion(54 strains,accounting for 20.61%),followed by Escherichia coli(35 strains,13.36%),Staphylococcus aureus(26 strains,10.00%),Pseudomonas aeruginosa(19 strains,7.25%),Haemophilus influenzae(15 strains,5.73%),Acinetobacter baumannii(13 strains,4.96%)and others(70 strains,26.72%).Klebsiella pneumoniae had resistance rate of 13.33%to carbapenems,with resistance rates to cephalosporins and aminoglycosides ranging of 15%-20%,and a resistance rate of 13.64%to quinolones.Escherichia coli showed a resistance rate of 30%-50%to cephalosporins,10%-30%to aminoglycosides,and 37.93%to quinolones.Pseudomonas aeruginosa exhibited a high resistance rate of 80.00%to ceftazidime,with resistance rates of 10%-20%to piperacillin and piperacillin/tazobactam,and resistance rates of 13.33%and 20.00%to imipenem and meropenem.Haemophilus influenzae had a resistance rate of 13.33%to piperacillin,while Acinetobacter baumannii showed resistance rate of 81.82%to carbapenems.Additionally,Staphylococcus aureus had resistance rate of 100.00%to penicillin and 21.70%to oxacillin.Conclusions The bacteria isolated from ICU are still predominantly Gram negative(G^(-))bacteria,with Klebsiella pneumoniae and Escherichia coli being the most common.The resistance situation is severe.Regular monitoring of the main bacterial composition and resistance patterns in ICU is crucial for guiding the rational use of antibiotics.

关 键 词：病原学 重症医学科 细菌 耐药 

分 类 号：R446.5[医药卫生—诊断学]