2020—2022年呼吸重症监护室细菌病原谱及耐药性分析  

Bacterial pathogen spectrum and drug resistance in respiratory intensive care unit in 2020-2022

作　　者：李娟[1] 吕凸 冯丽娜[1] 汪倩钰 黄韵 李从荣[1] 蔡璇[1] LI Juan;LYU Tu;FENG Lina;WANG Qianyu;HUANG Yun;LI Congrong;CAI Xuan(Department of Clinical Laboratory,Renmin Hospital of Wuhan University,Wuhan,Hubei 430060,China;Hubei Provincial Centre for Disease Control and Prevention,Wuhan,Hubei 430079,China)

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060 [2]湖北省疾病预防控制中心,湖北武汉430070

出　　处：《公共卫生与预防医学》2024年第6期89-92,共4页Journal of Public Health and Preventive Medicine

基　　金：职业危害识别与控制湖北省重点实验室开放基金(OHIC2022G12);湖北省科技厅重点研发项目(2022BCE010,2020BCA090,2021BCA148)。

摘　　要：目的了解武汉大学人民医院呼吸重症监护室(RICU)住院患者感染病原菌特点及其药物敏感性。方法回顾性分析该院2020年1月至2022年12月呼吸重症监护室(RICU)送检的细菌培养标本,经Bruker质谱仪鉴定细菌类别和Phoenix 100进行药敏,用WHONET 5.6软件进行抗菌药物敏感性分析。结果共分离出细菌1157株,其中革兰阴性菌878株(75.89%),革兰阳性菌279株(24.11%)。检出率最高的前五位是鲍曼不动杆菌(25.50%)、铜绿假单胞菌(18.76%)、肺炎克雷伯菌(13.83%)、金黄色葡萄球菌(6.57%)、大肠埃希菌(5.70%)。其中鲍曼不动杆菌耐药性极强,仅对黏菌素、米诺环素、替加环素有较高的敏感性;革兰阳性菌以金黄色葡萄球菌占比(6.57%)最高,其中耐甲氧西林金黄色葡萄球菌(MRSA)有不断增高的趋势。结论近三年该院呼吸重症监护室(RICU)患者标本中检出致病菌株以革兰阴性菌为主,其中最主要的是鲍曼不动杆菌、铜绿假单胞菌、肺炎克雷伯菌,对多种抗菌药物有较高的耐药率,所以临床应加强对RICU的耐药菌株监测,以便临床合理地使用抗菌药物,从而提高抗菌效果。Objective To understand the infectious pathogen characteristics and drug sensitivity of hospitalized patients in the respiratory intensive care unit(RICU)of Renmin Hospital of Wuhan University.Methods Bacterial culture samples sent from the RICU of our hospital from January 2020 to December 2022 were retrospectively analyzed.The bacterial types were identified by Bruker mass spectrometer,and the Phoenix 100 was used for drug sensitivity analysis.The antimicrobial susceptibility was analyzed by WHONET 5.6 software.Results A total of 1157 strains of bacteria were isolated,including 878 strains of Gram-negative bacteria(75.89%)and 279 strains of Gram-positive bacteria(24.11%).The top five with the highest detection rate were Acinetobacter baumannii(25.50%),Pseudomonas aeruginosa(18.76%),Klebsiella pneumoniae(13.83%),Staphylococcus aureus(6.57%)and Escherichia coli(5.70%).Among them,Acinetobacter baumannii was extremely drug-resistant,only showing relatively high sensitivity to colistin,minocycline,and tigecycline.Staphylococcus aureus accounted for the highest proportion of Gram-positive bacteria(6.57%),with methicillinresistant Staphylococcusaureus(MRSA)showing a continuous increase.Conclusion In the past three years,Gramnegative bacteria had been the main pathogenic bacteria detected in the RICU of our hospital.The main bacteria Acinetobacter baumannii,Pseudomonas aeruginosa,and Klebsiella pneumoniae,which a high resistance rate to various antibiotics.Therefore,clinical monitoring of resistant strains in RICU should be strengthened to facilitate rational use of antibiotics and improve antibacterial effect.

关 键 词：呼吸重症监护室 细菌感染 病原谱 耐药性 合理用药 

分 类 号：R181[医药卫生—流行病学]