2016—2018年天津市蓟州区人民医院病原菌的分布及耐药性分析

Analysis on distribution and drug resistance of pathogenic bacteria in the People’s Hospital of Jizhou District, Tianjin from 2016 to 2018

目的对2016-2018年天津市蓟州区人民医院医院感染病原菌的分布特点及耐药性进行分析,为临床合理用药及预防医院感染提供依据。方法收集2016-2018年天津市蓟州区人民医院微生物送检标本7897份作为样本,并对其进行细菌培养和药敏试验,对病原菌的分布及耐药性进行分析。结果共分离出病原菌7 897株,其中革兰阴性菌5 490株,构成比为69.52%,主要包括肺炎克雷伯菌(1981株,25.09%)、大肠埃希菌(1756株,22.24%)、铜绿假单胞菌(757株,9.59%)、鲍曼不动杆菌(523株,6.62%)等;革兰阳性菌2407株,构成比为30.48%,主要包括金黄色葡萄球菌(1017株,12.88%)、表皮葡萄球菌(668株,8.46%)等。肺炎克雷伯菌对阿米卡星、美罗培南、亚胺培南、头孢替坦敏感,对氨苄西林的耐药率最高,为99.32%;大肠埃希菌均对美罗培南、亚胺培南敏感,对氨苄西林、四环素的耐药率较高,分别为74.42%、72.87%;铜绿假单胞菌对左氧氟沙星、哌拉西林敏感,对氨苄西林、头孢呋辛钠、头孢曲松、头孢替坦氨的耐药率为100.00%;鲍曼不动杆菌对氨苄西林、氨曲南、呋喃妥因、头孢呋辛钠、头孢替坦氨的耐药率为100.00%,对其他抗菌药呈现不同耐药性。革兰阳性菌中金黄色葡萄球菌对青霉素、红霉素、克林霉素的耐药性较高,耐药率分别为89.99%、76.77%、73.39%;表皮葡萄球菌对青霉素、红霉素、苯唑西林的耐药性较高,耐药率分别为89.90%、73.39%、69.70%。对万古霉素、替考拉宁敏感。结论天津市蓟州区人民医院感染病原菌以革兰阴性菌最为多见,耐药现象较为严重,加强对医院感染病原学检查及耐药性监测有助于促进临床合理用药。

Objective To analyze the distribution characteristics and drug resistance of nosocomial infection pathogens in the People’s Hospital of Jizhou District, Tianjin from 2016 to 2018, so as to provide a basis for rational clinical use and prevention of nosocomial infection. Methods From 2016 to 2018, 7 897 microorganism samples were collected in the People’s Hospital of Jizhou District, Tianjin from 2016 to 2018 as samples, and bacterial culture and drug susceptibility test were carried out to analyze the distribution and drug resistance of pathogenic bacteria. Results A total of 7 897 strains of pathogenic bacteria were isolated, of which 5 490 strains were Gram-negative, with a composition ratio of 69.52%, including Klebsiella pneumoniae(1 981 strains, 25.09%), Escherichia coli(1 756 strains, 22.24%), Pseudomonas aeruginosa(757 strains, 9.59%), and Acinetobacter baumannii(523 strains, 6.62%). There were 2 407 Gram-positive bacteria with a composition ratio of 30.48%, mainly including Staphylococcus aureus(1 017 strains, 12.88%) and Staphylococcus epidermidis(668 strains, 8.46%). K. pneumoniae was sensitive to amikacin, meropenem, imipenem, and cefotetan, and the drug resistance rate of ampicillin was the highest(99.32%). E. coli was sensitive to meropenem and imipenem, and the drug resistance rate to ampicillin and tetracycline was the most serious, which was 74.42% and 72.87%, respectively. P. aeruginosa was sensitive to levofloxacin and piperacillin, and the drug resistance rate to ampicillin, cefuroxime sodium,ceftriaxone and ceftitan were 100.00%. The drug resistance rate of A. baumannii to ampicillin, amitracillin, furantoin, cefuroxime sodium, and ceftitan were 100.00%, and showed different drug resistance to other antibiotics. S. aureus was highly resistant to penicillin, erythromycin, and clindamycin, with the drug resistance rates of 89.99%, 76.77%, and 73.39%, respectively. S. epidermidis was highly resistant to penicillin, erythromycin, and benzocillin, with drug resistance rates of 89.90%, 73.39%, and 69.70%, respectively. It was sensitive to vancomycin and tekola. Conclusion Gram-negative bacteria are the most common pathogenic bacteria in the People’s Hospital of Jizhou District, Tianjin, and drug resistance is relatively serious. Therefore, strengthening the pathogenic examination and drug resistance monitoring of nosocomial infection can promote rational drug use in clinic.