2019-2021年某三甲综合医院感染现状及病原菌耐药性分析  

Analysis of infection status and drug resistance of pathogenic bacteria in a tertiary general hospital from 2019 to 2021

作　　者：路晓芸 张鹏亮 贾沂潼 张银萍 沈丽 杨志芳 王晶[4] LU Xiaoyun;ZHANG Pengliang;JIA Yitong;ZHANG Yinping;SHEN Li;YANG Zhifang;WANG Jing(School of Public Health,Xi'an Jiaotong University Health Science Center,Xi'an 710061;Disease Control and Prevention Department,the First Affiliated Hospital of Air Force Military Medical University,Xi'an 710032;Nursing Department,Xi'an Jiaotong University Health Science Center,Xi'an 710061;Gastroenterology Department,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710004,China)

机构地区：[1]西安交通大学医学部公共卫生学院,陕西西安710061 [2]空军军医大学第一附属医院疾病预防控制科,陕西西安710032 [3]西安交通大学医学部护理系,陕西西安710061 [4]西安交通大学第二附属医院消化内科,陕西西安710004

出　　处：《临床医学研究与实践》2024年第35期1-5,共5页Clinical Research and Practice

基　　金：空军军医大学第一附属医院2019年度学科助推计划(No.XJZT19ML43)。

摘　　要：目的探究2019—2021年医院感染现状,分析常见病原菌耐药情况,为医院感染的预防控制工作提供理论依据。方法选取2019年1月至2021年12月某三甲综合医院临床科室送检的住院时间在48 h以上患者的病原学标本,分析医院感染发生情况、病原菌种类以及常见病原菌耐药性。结果2019—2021年医院感染发生率分别为1.52%、1.33%、1.27%,呈下降趋势(P<0.05);下呼吸道、上呼吸道、泌尿道为常见医院感染部位。检出前5位病原菌分别为鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌及大肠埃希菌。大肠埃希菌及肺炎克雷伯菌对第一代头孢菌素类抗生素耐药率较高(>90%);铜绿假单胞菌对亚胺培南、氨曲南耐药率较高(39.18%~48.98%);鲍曼不动杆菌耐药形势严峻,对多种抗生素的耐药率>50%;金黄色葡萄球菌对红霉素的耐药率波动较大(11.45%~68.08%),耐甲氧西林金黄色葡萄球菌(MRSA)检出率为51.92%~54.30%。结论医院感染率整体呈下降趋势,常见病原菌对抗菌药物耐药率高,鲍曼不动杆菌耐药性尤为严重,应该继续加强抗菌药物合理使用管理及医院感染防控,控制多重耐药菌株的产生。Objective To explore the current situation of hospital infection in 2019—2021,analyze the drug resistance of common pathogenic bacteria,and provide theoretical basis for the prevention and control of hospital infection.Methods The pathogenic specimens of patients who were hospitalized for more than 48 h in the clinical department of a tertiary general hospital from January 2019 to December 2021 were selected to analyze the occurrence of nosocomial infection,the types of pathogenic bacteria and the drug resistance of common pathogenic bacteria.Results The incidence of nosocomial infection in 2019—2021 was 1.52%,1.33%and 1.27%,respectively,showing a downward trend(P<0.05);lower respiratory tract,upper respiratory tract and urinary tract were the common sites of nosocomial infection.The top five pathogens were Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa,Staphylococcus aureus and Escherichia coli.Escherichia coli and Klebsiella pneumoniae had a high resistance rate(>90%)to first generation cephalosporin antibiotics;the resistance rates of Pseudomonas aeruginosa to imipenem and aztreonam were high(39.18%-48.98%);the drug resistance situation of Acinetobacter baumannii was severe,and the drug resistance rate to multiple antibiotics was more than 50%;the resistance rate of Staphylococcus aureus to erythromycin fluctuated greatly(11.45%-68.08%),and the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 51.92%-54.30%.Conclusion The overall hospital infection rate is showing a downward trend,and common pathogens have a high resistance rate to antibiotics.Acinetobacter baumannii has particularly severe resistance.It is necessary to continue to strengthen the rational use of antibiotics and the prevention and control of hospital infection,and control the production of multi-drug resistant strains.

关 键 词：医院感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]