2014—2019年浙江地区某肿瘤医院尿路感染病原菌的分布及耐药变迁

Distribution and change of drug resistance profile of pathogens causing urinary tract infection in a tumor hospital in Zhejiang province 2014—2019

目的了解中国科学院大学附属肿瘤医院肿瘤患者尿路感染病原菌的分布及耐药变迁。方法回顾性分析中国科学院大学附属肿瘤医院2014年1月—2019年12月尿路感染的病原菌,通过Whonet 5.6软件对数据进行统计分析。结果中国科学院大学附属肿瘤医院6年间尿路感染病原菌共计6149株,革兰阴性细菌占67.1%,革兰阳性细菌占28.5%,真菌占4.4%。前5位的分别是大肠埃希菌、粪肠球菌、肺炎克雷伯菌、鲍曼不动杆菌复合体和表皮葡萄球菌。6年间大肠埃希菌和肺炎克雷伯菌对碳青霉烯类敏感性较好,粪肠球菌和表皮葡萄球菌对万古霉素敏感性较好,未发现替加环素耐药。结论6年间肿瘤医院尿路感染的病原菌以革兰阴性细菌为主,耐药现象较为普遍,应根据药敏结果合理使用抗生素,加强细菌耐药的监测,减少耐药菌株的产生。

Objective To understand the distribution and drug resistance characteristics of pathogens,so as to provide the basis for the clinical reasonable use of antibiotics.Methods A retrospective study of pathogens in patients with urinary tract infection(January 2014 through December 2019)from the Cancer Hospital of University of Chinese Academy of Sciences was analyzed.Bacterial isolation and identification and drug sensitivity tests were used to detect and analyze pathogenic bacteria.Results A total of 6,149 strains of pathogens were isolated from specimens of patients with urinary tract infection.Among them,Gram-negative bacteria and Gram-positive bacteria accounted for 67.1%and 28.50%respectively,and fungi accounted for 4.40%.The top five were Escherichia coli,Enterococcus faecalis,Klebsiella pneumoniae,Acinetobacter baumannii complex,and Staphylococcus epidermoides.Within six years,Escherichia coli and Klebsiella pneumoniae were more sensitive to carbapenems,while Enterococcus faecalis and Staphylococcus epidermidis were more sensitive to vancomycin.No drug resistance of tigecycline were found.Conclusion Gram-negative bacteria were the predominant pathogens in the urinary tract infection in the tumor hospital in six years,where drug resistance appeared relatively common.Antibiotics should be used reasonably according to drug sensitivity results,and the monitoring of bacterial drug resistance should be strengthened to reduce the generation of drug-resistant strains.