2020年河南省100所医院神经内科病原菌分布及耐药性分析

Distribution and drug resistance analysis of pathogenic bacteria in neurology department of 100 hospitals in Henan province in 2020

目的:探讨2020年河南省100所医院神经内科病原菌的分布及耐药性,为医院感染的防控和临床抗菌药物的合理应用提供依据。方法:收集河南省细菌耐药监测网上有关神经内科病原菌分布及耐药性的相关数据,采用WHONET进行统计分析。结果:共纳入分析的细菌总数为7 507株,其中革兰阴性菌6 094株(81.2%);革兰阳性菌1 413株(18.8%)。结果显示,金黄色葡萄球菌和屎肠球菌对青霉素平均耐药率达89.9%和89.6%,未检测出耐替考拉宁、万古霉素和利奈唑胺的金黄色葡萄球菌。肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌、鲍曼不动杆菌对亚胺培南和美罗培南平均耐药率分别是23.4%,1.4%,23.1%,69.5%。三级医院纳入分析的细菌总数为6 590株,二级医院为917株;三级医院中肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌对碳青霉烯类药物耐药率均高于二级医院。结论:该省神经内科患者的病原菌以革兰阴性菌为主,部分病原菌耐药情况严重,尤其是鲍曼不动杆菌,各级医院应该加强防控措施,规范抗菌药物使用,保障医疗安全。

OBJECTIVE To explore the distribution and drug resistance of pathogenic bacteria in the neurology department of 100 hospitals in Henan province in 2020,so as to provide a basis for the prevention and control of nosocomial infections and the rational application of clinical antibacterial drugs.METHODS The data on the distribution and drug resistance of pathogens in neurology department on China Antimicrobial Surveillance Network(CHINET) in Henan province were collected and statistically analyzed by WHONET.RESULTS A total number of 7 507 strains of bacteria were included in the analysis, including 6 094 strains(81.2%) of Gram-negative bacteria, and 1 413 strains(18.8%) of Gram-positive bacteria. The result showed that the average resistance rates of Staphylococcus aureus and Enterococcus faecium to penicillin were 89.9% and 89.6%,and Staphylococcus aureus resistant to teicoplanin, vancomycin and linezolid were not detected. The average resistance rates of Klebsiella pneumoniae,Escherichia coli,Pseudomonas aeruginosa,and Acinetobacter baumannii to imipenem and meropenem were 23.4%,1.4%,23.1%,and 69.5%,respectively. The total number of bacteria included in the analysis was 6 590 in tertiary care hospitals and 917 strains in the secondary care hospital. The average resistance rates of Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem and meropenem in tertiary care hospitals are higher than those in the secondary care hospital.CONCLUSION The main pathogens of neurology patients in our province are gram-negative bacteria, and some pathogens have serious drug resistance, especially Acinetobacter baumannii. Hospitals at all levels should strengthen prevention and control measures, standardize the rational use of antibacterial drugs, and ensure medical safety.