某医院重症监护室和普通病区非发酵菌检出情况及耐药性比较分析

Comparison and Analysis of Drug resistance of Main non Fermenting Bacteria in Intensive Care Unit and General Ward of Primary Hospital

目的探讨重症监护室(ICU)和普通病区非发酵菌的检出情况及耐药特点,为促进临床合理使用抗菌药物提供参考。方法统计分析某综合医院2016年1月—2020年12月ICU和普通病区非发酵菌的菌种构成及耐药性,比较其差异性。结果共分离到非发酵菌1034株,其中ICU 245株,普通病区789株。ICU和普通病区分离的非发酵菌均以鲍曼不动杆菌、铜绿假单胞菌、嗜麦芽寡养单胞菌和洋葱伯克霍尔德菌排前4位,后3种病原菌的构成比情况在两个病区存在差异性(P<0.05)。药敏结果显示,除替加环素和氨曲南外,两个病区分离鲍曼不动杆菌对其他抗菌药物的耐药性存在明显差异,且ICU分离菌株的耐药率均高于普通病区分离菌株(P<0.05);除哌拉西林/三唑巴坦、头孢吡肟和头孢他啶外,铜绿假单胞菌对其他抗菌药物的耐药性无统计学差异(P>0.05)。结论该医院临床分离的非发酵菌以鲍曼不动杆菌和铜绿假单胞菌为主,ICU和普通病区非发酵菌对抗菌药物的耐药率存在不同程度的差异性,应引起医院抗菌药物临床应用管理相关部门的高度重视,临床药师能够在促进抗菌药物合理使用过程中发挥专业技术支撑作用。

Objective To investigate the detection and drug resistance characteristics of non fermentative bacteria in intensive care unit(ICU)and general wards,and to provide reference for promoting the rational use of antibiotics in clinic.Methods The composition and drug resistance of non fermenting bacteria in ICU and general ward of a general hospital from January 2016 to December 2020 were statistically analyzed,and the differences were compared.Results A total of 1034 strains of non-fermentative bacteria were isolated,including 245 strains in ICU and 789 strains in common ward.Acinetobacter baumannii,Pseudomonas aeruginosa,Stenotrophomonas maltophilia and Burkholderia cepacia were the top four non fermenting bacteria isolated from ICU and general wards.The constituent ratio of the latter three pathogens was different between the two wards(P<0.05).The antimicrobial susceptibility results showed that there were significant differences in the antimicrobial resistance of Acinetobacter baumannii isolated from the two wards except for tegecycline and aminotronam,and the drug resistance rates of ICU isolates were higher than those of the common wards(P<0.05).Except piperacillin/tazobactam,cefepime and ceftazidime,there was no statistical difference in the resistance of Pseudomonas aeruginosa to other antimicrobial agents(P>0.05).Conclusion Acinetobacter baumannii and Pseudomonas aeruginosa were the main non fermenting bacteria isolated in our hospital.The drug resistance rates of non fermenting bacteria in ICU and common wards were different in different degrees.Therefore,It should arouse great attention from relevant departments of the hospital’s clinical application and management of antimicrobial drugs,and clinical pharmacists can play a professional and technical support role in promoting the rational use of antibacterial drugs.