2016-2018年河南科技大附属医院胸外科重症监护室感染性疾病病原菌分布及耐药性分析

Distribution and drug resistance of infectious diseases in intensive care unit of Department of Thoracic Surgery of Henan University of Science and Technology from 2016 to 2018

目的分析2016-2018年河南科技大附属医院胸外科重症监护室感染性疾病病原菌的分布及耐药性。方法回顾性分析2016-2018年河南科技大附属医院胸外科重症监护室病原菌的分布和耐药性。结果 2016-2018年送检样本主要来自于痰液和尿液,且随着年限的增加,样本数逐渐增加。共检测样本36 298份,致病菌共检测出2 484株,检出率为6.84%。临床分离病原菌中分离率最高的为大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌、鲍曼不动杆菌和金黄色葡萄球菌。其中大肠埃希菌在2017年的分离率最高,为41.32%。2016-2018年主要病原菌的耐药率从总体来看,呈不断上升的趋势,其中大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对呋喃妥因和头孢唑啉的耐药率较高。2016-2018年大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌对呋喃妥因和头孢唑啉的耐药率均为100.00%,对厄他培南的耐药率较低,均为0.00%。肺炎克雷伯菌和铜绿假单胞菌对哌拉西林的耐药率上升最为明显,在2017年耐药率达到100.00%。金黄色葡萄球菌对氨苄西林、头孢唑啉、阿莫西林/克拉维酸、哌拉西林的耐药率较高,对阿米卡星、头孢他唑啶、厄他培南的耐药率较低;凝固酶阴性葡萄球菌对氨苄西林、环丙沙星、头孢唑啉、哌拉西林、氨曲南的耐药率较高,对阿米卡星、亚胺培南、左旋氧氟沙星、厄他培南的耐药率较低。结论 2016-2018年河南科技大附属医院感染病原菌的检出率逐年升高,病原菌的耐药性也有逐年上升的趋势,应引起感染科及其他相关部门的重视,严格控制抗生素的使用。

Objective To explore the distribution and drug resistance of infectious diseases in intensive care unit of Department of Thoracic Surgery of Henan University of Science and Technology from 2016 to 2018. Methods A retrospective survey was conducted to analyze the distribution and drug resistance of pathogenic bacteria in the intensive care unit of Department of Thoracic Surgery of Henan University of Science and Technology from 2016 to 2018. Results The samples submitted from 2016 to 2018 mainly came from sputum and urine, and the number of samples increased gradually with the increase of years. A total of 36 298 samples and 2 484 strains of pathogenic bacteria were detected, and the detection rate was 6.84%. Escherichia coli, Pseudomonas aeruginosa, Klebsiella pneumoniae, Acinetobacter baumannii, and Staphylococcus aureus had the highest isolation rate among clinical isolates. E. coli had the highest separation rate in 2017 with 41.32%. The resistance rate of major pathogens from 2016 to 2018 was on a rising trend. Among them, E. coli, K. pneumonia, and P. aeruginosa had high resistance rate to nitrofurantoin and cefazolin. The resistance rates of E. coli, K. pneumonia, and P. aeruginosa to nitrofurantoin and cefazolin were 100.00% from 2016 to2018, and the resistance rate to ertapenem was low, both were 0. The resistance rate of K. pneumoniae and P. aeruginosa to piperacillin increased the most obvious, and the resistance rate reached 100.00% in 2017. S. aureus had higher resistance to ampicillin, cefazolin, amoxicillin/clavulanic acid, and piperacillin, and lower resistance to amikacin, ceftazidime, and ertapenem. Coagulase-negative staphylococci were highly resistant to ampicillin, ciprofloxacin, cefazolin, piperacillin, and aztreonam, and were resistant less to amikacin, imipenem, levofloxacin, and ertapenem. Conclusion The detection rate of nosocomial pathogens in Henan Science and Technology Affiliated Hospital increased gradually from 2016 to 2018, and the drug resistance of pathogenic bacteria also increased year by year. It should cause the attention of infectious diseases and other related departments, and strictly to control the use of antibiotics.