2022年北京康复医院住院患者细菌耐药监测分析

An Analysis of Bacterial Detection and Drug Resistance of Hospitalized Patients in Beijing Rehabilitation Hospital in 2022

目的分析2022年北京康复医院住院患者细菌检出情况及耐药特点,为临床合理用药及院感管理提供依据。方法回顾性分析2022年北京康复医院住院患者中非重复检测的细菌菌株,根据美国临床和实验室标准化协会(CLSI)2022年标准判读药敏结果,采用WHONET5.6软件进行数据分析。结果2022年微生物室共分离1946株非重复细菌菌株,其中革兰阴性菌1552株,占79.8%,革兰阳性菌394株,占20.2%。检出最多的4种革兰阴性菌为肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌、鲍曼不动杆菌。革兰阳性菌以肠球菌和葡萄球菌为主,其中肠球菌183株,以屎肠球菌稍多,葡萄球菌194株,凝固酶阴性葡萄球菌多于金黄色葡萄球菌。分离菌标本分布以尿液和痰液标本为主,血标本占9.7%,其余标本类型少。分离菌最多的临床科室是神经康复中心,占30.3%。肠杆菌目中肺炎克雷伯菌对碳青霉烯类药物耐药率高,呈现多重耐药甚至泛耐药。铜绿假单胞菌对阿米卡星耐药率低于10%,对亚胺培南及美洛培南的耐药率为45.1%和35.6%。鲍曼不动杆菌仅对替加环素耐药率低于10%,对其他常用抗菌药物耐药率高于50%。屎肠球菌对万古霉素耐药率高达33.3%,而粪肠球菌仅1.4%。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为占61.6%,未检出对万古霉素耐药的葡萄球菌。结论我院临床分离的病原菌主要是耐药性严重的革兰阴性菌,医院在合理规范用药、加强院感管理等方面,要给予高度重视。

Objective To analyze characteristics of bacterial identification and drug resistance among inpatients at Beijing Rehabilitation Hospital in 2022.Methods Throughout 2022,a retrospective analysis was conducted on non-repetitive bacterial strains isolated from inpatients at Beijing Rehabilitation Hospital.The drug susceptibility of these strains was determined based on the 2022 CLSI M100 standard.The collected data were analyzed using WHONET5.6 software.Results By the year 2022,the microbiological laboratory successfully isolated a total of 1946 distinct bacterial strains,out of which 1552 were Gram negative bacteria,constituting 79.8%of the total,while 394 strains were Gram positive bacteria,representing 20.2%.Klebsiella pneumoniae,Pseudomonas aeruginosa,Escherichia coli,and Acinetobacter baumannii were the four most common types of Gram-negative bacteria.Gram positive bacteria mainly included Enterococcus and Staphylococcus.A total of 183 strains of Enterococcus were identified.Among 194 strains of Staphylococcus,coagulase negative Staphylococcus was found to be more common than Staphylococcus aureus.The main types of specimens were urine and sputum samples,while blood samples only made up 9.7%.The Neurological Rehabilitation Center had the highest number of isolated bacterial strains,accounting for 30.3%.Klebsiella pneumoniae displayed the highest resistance rate towards carbapenem antibiotics.Pseudomonas aeruginosa exhibited high sensitivity towards amikacin,with a resistance rate below 10%.The resistance rates to imipenem and meropenem were 45.2%and 35.6%,respectively.Acinetobacter baumannii demonstrated the highest susceptibility to tigecycline.In contrast,the resistance rates for other commonly utilized antibiotics exceed 50%.Enterococcus faecalim showed a significantly elevated resistance rate of 33.3%against vancomycin,whereas Enterococcus faecalis displayed a mere 1.4%resistance rate.The detection rate of methicillin resistant Staphylococcus aureus(MRSA)was 61.6%,while coagulase negative Staphylococcus(MRCNS)had a detection rate of 89.8%.No vancomycin resistant Staphylococcus was found.Conclusion The predominant bacteria found in our hospital belong to the Gram-negative category,and its drug resistance is exceptionally severe.It is very important to monitor bacterial resistance and strengthen the management of hospital-level infections.