某医院临床病原菌分布特点及耐药性分析  

Distribution Characteristics and Drug Resistance Analysis of Clinical Pathogenic Bacteria in a Hospital

作　　者：杨艳琳 陈虎 王超 Yang Yanlin;Chen Hu;Wang Chao(Department of No.2 Internal Medicine,No.78 Army Hospital,Mudanjiang,Heilongjiang,157000,China)

机构地区：[1]陆军第七十八集团军医院内二科,黑龙江牡丹江157000 [2]陆军第七十八集团军医院检验病理科,黑龙江牡丹江157000 [3]陆军第七十八集团军医院质量管理科,黑龙江牡丹江157000

出　　处：《黑龙江医学》2025年第2期194-197,共4页Heilongjiang Medical Journal

摘　　要：目的:回顾性分析某医院2022年临床送检标本病原菌分布特点及耐药性,以期为临床医生合理选择抗生素以及医院感染监控提供依据。方法:按照《全国临床检验操作规范》以及产品配套的说明书,采用山东鑫科全自动微生物鉴定仪及其配套使用的鉴定和药敏板对2022年全年送检标本进行细菌培养、鉴定及药敏试验。结果:2022年临床送检标本检出697株病原菌,其中革兰阳性菌377株(54.09%),排名前5的细菌分别为金黄色葡萄球菌、卡他莫拉菌、表皮葡萄球菌、粪肠球菌、肺炎链球菌;革兰阴性菌279株(40.03%),排名前5的细菌分别为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、阴沟肠杆菌、产酸克雷伯菌。革兰阳性菌中金黄色葡萄球菌、粪肠球菌敏感药物有头孢哌酮/舒巴坦、哌拉西林/他唑巴坦,但均发现耐万古霉素、利奈唑胺、替考拉宁菌株。卡他莫拉菌、表皮葡萄球菌、肺炎链球菌敏感药物有米诺环素、利奈唑胺、万古霉素、替考拉宁。革兰阴性菌中大肠埃希菌、肺炎克雷伯菌、产酸克雷伯菌仅对多西环素、替加环素敏感,对青霉素类、头孢类、喹诺酮类均存在明显耐药,耐药率超过20%。肠球菌、阴沟肠杆菌检出率逐渐升高,耐药问题日益严重。结论:革兰阳性菌检出率高于革兰阴性菌,常见病原菌谱与国家耐药监测结果相似,临床耐药率较高,需要进一步规范抗生素使用,降低耐药率、提高治疗效果。Objective:A retrospective analysis was carried out on the distribution characteristics and drug resistance of pathogenic bacteria in specimens sent for clinical examination in a hospital in 2022,in order to provide a basis for clinicians to rationally choose antibiotics and monitor nosocomial infections.Methods:In accordance with the“National Clinical Laboratory Operation Specification”and the instructions for supporting the product,Shandong Xinke automatic microbial identification instrument and its supporting identification and drug susceptibility plate were used to carry out bacterial culture,identification and drug susceptibility testing of specimens sent for examination throughout 2022.Results:In 2022,a total of 697 pathogenic bacteria were detected,including 377 gram-positive cocci(54.09%).5 of the most common bacteria were Staphylococcus aureus,moraxella catarrhalis,staphylococcus epidermidis,enterococcus faecalis and streptococcus pneumoniae,and 279 gram-negative cocci(40.03%).The top 5 bacteria were escherichia coli,pseudomonas aeruginosa,klebsiella pneumoniae,enterobacter cloacae and klebsiella acid-producing bacteria.Sensitive drugs for staphylococcus aureus and enterococcus faecalis in gram positive bacteria include cefoperazone/sulbactam,piperacillin/tazobactam,and vancomycin,linezolid and tegacyclin resistant strains of staphylococcus aureus and enterococcus faecaliopers were found.Streptococcus pneumoniae,staphylococcus epidermidis and streptococcus pneumoniae was sensitive to minocycline,linezolid,vancomycin,and teicoplanin.Among gram-negative bacteria,escherichia coli,klebsiella pneumoniae,and kebsiella acid-producing bacteria were only sensitive to doxycycline and tigecycline.There was obvious resistance to penicillins,cephalosporins and quinolones,and the drug resistance rate exceeded 20%.The detection rate of enterococci and Enterobacter cloacae was gradually increasing,and the problem of drug resistance became increasingly serious.Conclusion:The detection rate of Gram positive bacteria is

关 键 词：病原菌分布 耐药性 抗菌药物 

分 类 号：R36[医药卫生—病理学]