某院感染科病房住院患者常见病原菌分布及耐药性分析

The distribution and drug resistance of pathogens isolated from patients in department of infectious diseases

目的对感染科病房住院患者临床常见病原菌的分布及其耐药性进行分析,为临床预防和治疗感染性疾病提供依据。方法回顾性分析中国医科大学附属第一医院感染科病房2012年1月至2016年12月从住院患者体液及组织样本中分离的病原菌,对其耐药情况进行分析。结果 5年中感染科共分离出非重复病原菌1 266株,其中革兰阴性菌786株,占62.09%,分离率居前3位的是大肠埃希菌、肺炎克雷伯菌以及铜绿假单胞菌,分别占17.22%、15.24%和10.58%;革兰阳性菌共480株,占37.91%,分离率居前3位的是屎肠球菌、草绿色链球菌以及金黄色葡萄球菌,分别占9.79%、7.50%和6.00%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为66.7%和28.8%。大肠埃希菌对亚胺培南和美罗培南的耐药率分别为0.95%和3.79%,肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别为2.80%和2.80%。结论我院感染科病房住院患者感染病原菌以革兰阴性菌为主,为有效地控制和避免耐药菌感染的发生,临床应根据药敏试验结果合理应用抗菌药物。

Objective To analyze the distribution and drug resistance of the pathogens in hospitalized patients with infections in the department of infectious diseases,so as to provide evidences for the prevention and treatment.Methods The specimens of body fluids and tissues of inpatients during January 2012 and December 2016 in our hospital were collected,and the antimicrobial resistances of the pathogens were analyzed with retrospective analysis.Results 1,266 strains of pathogenic bacteria were isolated.786 strains（62.09%）were Gram-negative bacteria,with the top three pathogens being Escherichia coli（17.22%）,Klebsiella pneumoniae（15.24%）and Pseudomonas aeruginosa（10.58%）.480 strains（37.91%）were Gram-positive bacteria,with top three pathogens being Enterococcus（9.79%）,Streptococcus viridans（7.50%）and Staphylococcus aureus（6.00%）.The detection rate of ESBLs was 66.7%in Escherichia coli and 28.8%in Klebsiella pneumoniae.The resistance rate of Escherichia coli was 0.95%to Imipenem and3.79%to Meropenem,while that of Klebsiella pneumoniae was 2.80% to Imipenem and 2.80% to Meropenem.Conclusion Gram-negative bacteria were the main pathogens in the department of Infectious diseases.To effectively control infections and prevent the emergence of drug resistance,antibiotics should be reasonably selected according to drug-sensitivity test.