某三甲医院2017年至2019年临床分离菌分布与耐药性分析

Analysis of the distribution and drug resistance of clinical isolates in a third-class hospital hospital from 2017 to 2019

目的回顾性分析本院三年临床分离菌分布特征及抗菌药物耐药情况,为感染性疾病患者的诊断和治疗提供参考依据。方法选取2017-2019年本院住院患者分离培养菌落,采用全自动微生物分析系统及配套细菌鉴定药敏卡试验。结果病原菌占比前五位细菌为鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌。药敏试验结果显示,碳青霉烯类耐药鲍曼不动杆菌占87.6%,碳青霉烯类耐药肺炎克雷伯菌(CRKP)占比达37.7%,碳青霉烯类耐药铜绿假单胞菌(CRPA)占49.6%,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为44.7%。结论利奈唑胺和万古霉素可作为治疗葡萄球菌所致血流感染重症患者的首选用药。临床医生要高度重视合理使用抗菌药物,减少碳青霉烯类耐药菌株的传播。

Objective The distribution characteristics of clinical isolates and antibiotic resistance in our hospital in the past three years were analyzed retrospectively,so as to provide reference basis for the diagnosis and treatment of patients with infectious diseases.Methods The colonies of inpatients in our hospital from 2017 to 2019 were selected to isolate and culture colonies,and the fully automatic microbial analysis system and supporting bacterial identification drug sensitivity card test were used.Results The top five pathogens were Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus.The results of drug sensitivity test showed that carbapenem-resistant Acinetobacter baumannii accounted for 87.6%,carbapenem-resistant Klebsiella pneumoniae(CRKP)accounted for 37.7%,carbapenem-resistant Pseudomonas aeruginosa(CRPA)accounted for 49.6%,and the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 44.7%.Conclusion Linezolid and vancomycin can be used as the first choice for the treatment of severe patients with bloodstream infection caused by Staphylococcus..Clinicians should attach great importance to the rational use of antibiotics to reduce the spread of carbapenem-resistant strains.