2013—2016年某大型综合性医院呼吸道感染常见菌的耐药性分析

Distribution and drug resistance analysis of three common bacteria in respiratory tract infection in People’s Hospital of Wuhan University(2013-2016)

目的 了解武汉大学人民医院呼吸道感染三种常见病原菌的分布及耐药变迁,为临床医生合理使用抗生素提供理论依据。方法 回顾性分析该院2013年1月至2016年12月临床微生物室分离的流感嗜血杆菌、卡他莫拉菌和肺炎链球菌的药敏情况,采用WHONET5.6和Excel2016软件进行统计作图分析。结果 呼吸道感染3种常见病原菌的检出率四年间总体呈上升趋势;流感嗜血杆菌主要检出于春夏季,卡他莫拉菌和肺炎链球菌主要检出于冬季;3种病原菌四季的检出率分别为9.50%(426/4486)、9.28%(449/4836)、4.57%(207/4531)、9.86%(459/4655),差异具有统计学意义(P<0.001);流感嗜血杆菌对阿莫西林/克拉维酸、环丙沙星、头孢噻肟、左氧氟沙星和美罗培南的敏感率均>90%;卡他莫拉菌对阿莫西林/克拉维酸、头孢噻肟较敏感,对大环内酯类和复方新诺明耐药率<37%;肺炎链球菌对对头孢噻肟、左氧氟沙星、氯霉素、万古霉素、利奈唑胺等抗生素较为敏感,对青霉素、大环内酯类抗生素耐药率较高。结论 呼吸道感染3种常见病原菌四年间检出率和相关药物的耐药率均有所上升,因此根据耐药率的变化,针对每种病原菌选择合理的抗菌药物治疗是至关重要的。

Objective To understand the distribution and drug resistance changes of three common pathogens of respiratory tract infection in People′s Hospital of Wuhan University,to provide theoretical basis for clinicians to use antibiotics reasonably. Methods The susceptibility of Haemophilus influenzae,Moraxella catarrhalis and Streptococcus pneumoniae isolated from clinical microbiology laboratory from January 2013 to December 2016 in our hospital was analyzed retrospectively.Statistical analysis was performed using WHONET 5.6 and Excel 2016 software. Results The detection rate of three common pathogens of respiratory tract infections is generally on the rise in four years,Haemophilus influenzae mainly detected in spring and summer,Moraxella catarrhalis and S.pneumoniae were mainly detected in winter,The detection rates of the three pathogens were 9.50%(426/4 486),9.28%(449/4 836),4.57%(207/4 531)and 9.86%(459/4 655)respectively and the difference was statistically significant(P<0.001),The sensitivity rates of Haemophilus influenzae to amoxicillin/clavulanic acid,ciprofloxacin,cefotaxime,levofloxacin and meropenem were all more than 90%,Moraxella catarrhalis is more susceptible to amoxicillin/clavulanic acid and cefotaxime,with less than 37%resistance to macrolides and cotrimoxazole,Streptococcus pneumoniae on cefotaxime,levofloxacin,chloramphenicol,vancomycin,linezolid is more sensitive,but penicillin,macrolide antibiotic resistance is serious. Conclusion Respiratory infections three common pathogens detection rate of four years and related drug resistance rates have increased,therefore,according to the resistance rate changes,for each pathogen to choose a reasonable antimicrobial drug treatment is essential.