2017年-2023年某三甲医院四种革兰阴性菌临床分布及耐药性分析  

Clinical Distribution and Drug Resistance of the Four Gram-negative bacteria in a First-Class Hospital from 2017 to 2023

作　　者：郑远明[1] 郭润龙 周杰[1] 徐祎晗 Zheng Yuan-ming;Guo Run-long;Zhou Jie;Xu Yi-han(Affiliated Dalian Friendship Hospital of Dalian Medical University,Dalian Liaoning 116001;Health industry group of Liaoning province Fu Mining General Hospital,Fushun Liaoning 113006)

机构地区：[1]大连市友谊医院,辽宁大连116001 [2]辽宁省健康产业集团抚矿总医院,辽宁抚顺113006

出　　处：《国外医药(抗生素分册)》2024年第6期418-426,共9页World Notes on Antibiotics

摘　　要：目的分析大连市友谊医院近7年临床四种主要革兰阴性菌的临床分布及耐药性,帮助临床治疗革兰阴性菌感染合理使用抗菌药物。方法回顾性统计本院2017年1月—2023年12月期间四种主要革兰阴性菌感染患者标本共6900株,采用Whonet 5.6软件分析。结果四种主要革兰阴性菌分别是肺炎克雷伯菌(2126株,17.9%)、大肠埃希菌(2105株,17.7%)、铜绿假单胞菌(1483株,12.5%)和鲍曼不动杆菌(1186株,10.0%);主要来源于痰液(2879株,41.7%)和尿液(2010株,29.1%);分布最广的科室为重症监护室(1498株,21.7%)和泌尿外科(1074株,15.6%)。2017年肺炎克雷伯菌对头孢唑啉耐药率最高(79.3%);2021年大肠埃希菌对氨苄西林的耐药率最高(85.9%);7年间,铜绿假单胞菌监测的抗菌药物耐药率相对较低;鲍曼不动杆菌监测的抗菌药物耐药率相对较高。结论医院需加强对临床感染革兰阴性菌的监测和管理,特别是多重耐药菌的监测对临床合理使用抗菌药物具有指导作用。Objective To analyze the clinical distribution and drug resistance of the four main clinical Gramnegative in Dalian Friendship Hospital in recent 7 years,and to help the rational use of antibiotics in the treatment of Gram-negative infections.Methods A total of 6900 strains of samples from patients infected with four major gram-negative bacteria in our hospital from January 2017 to December 2023 were retrospectively counted.WHONET 5.6 software was used for analysis.Results The four predominant gram-negative bacteria were Acinetobacter baumannii(ABA)(1186 strains,10.0%),Pseudomonas aeruginosa(PAE)(1483 strains,12.5%),Escherichia coli(ECO)(2105 strains,17.7%),and Klebsiella pneumoniae(KPN)(2126 strains,17.9%).The main sources were sputum(2879 strains,41.7%)and urine(2010 strains,29.1%),and the detection rate in sterile body fluids was low.The most widely distributed departments were the intensive care unit(1498 strains,21.7%)and urology(1074 strains,15.6%).The highest percentage of ampicillin resistance was recorded by ECO in 2021(85.9%),whereas the highest rate of cefazolin resistance was recorded by KPN in 2017.Over the past 7 years,the antimicrobial resistance rate monitored by PAE was relatively low.The antimicrobial resistance rate monitored by ABA is relatively high.Conclusion It is necessary to strengthen the monitoring and management of clinical negative bacteria,especially for multi-drug resistant bacteria,which can guide the rational use of antibiotics.

关 键 词：肺炎克雷伯菌 大肠埃希菌 铜绿假单胞菌 鲍曼不动杆菌 抗菌药物 多重耐药 

分 类 号：R978[医药卫生—药品]