2016年-2021年新昌地区胸腹水病原菌分布及耐药特征

Pathogen distribution in hydrothorax and ascites and its antibiotic resistance characteristics in Xinchang area from 2016 to 2021

目的探讨新昌地区胸腹水标本的病原学及耐药特征,为临床治疗和防控提供科学依据。方法回顾性分析2016年4月-2021年4月胸腹水标本。收集病患特征、病原体类型及抗菌药物敏感性测试结果等实验室数据。结果198株菌株源于183例患者,革兰阴性菌122株,占61.62%;革兰阳性菌63株,占31.82%;真菌13株,占6.56%。前3位分别是鲍曼不动杆菌、大肠埃希菌、金黄色葡萄球菌。革兰阳性菌对利奈唑胺、万古霉素呈100%敏感,对奎奴普丁、达福普丁、利福平保持10%以下的耐药率;革兰阴性菌对阿米卡星、替加环素保持30%以下的耐药率;耐亚胺培南革兰阴性杆菌数量呈逐年上升趋势(P<0.05)。结论胸腹水中病原菌以革兰阴性菌为主,但革兰阴性菌中鲍曼不动杆菌耐药严重,临床治疗中应结合药敏实验结果合理选用抗菌药物。

Objective To investigate the pathogenic characteristics and drug resistance of pleural and abdominal fluid samples in Xinchang area,and to provide scientific basis for clinical treatment and prevention and control.Methods The samples of hydrothorax and ascites from April 2016 to April 2021 were retrospectively analyzed.Laboratory data such as patient characteristics,pathogen types and antimicrobial sensitivity test results were collected.Results A total of 198 strains of pathogens derived from 183 patients were isolated,including 122 gram-negative strains(61.62%),63 gram-positive strains(31.82%),and 13 fungal strains(6.56%).The first three strains of bacteria were Acinetobacter baumannii,Escherichia coli,Staphylococcus aureus.Gram positive bacteria was 100%susceptible to vancomycin and linezolid.The drug resistance rates of the gram-positive bacteria to quinupristin/dalfopristin and rifampin were less than 10%;the chug resistance rates of the gram-negative bacteria to amikacin and tigecycline were less than 30%.The number of gram-negative bacilli resistant to imi-penem increased annually(P<0.05).Conclusion Gram-negative bacteria are the main pathogens in pleural and abdominal water,but the gram-negative bacteria are seriously resistant to Acinetobacter baumannii.Therefore,antibacterial agents should be rationally-selected in clinical treatment based on the results of drug sensitivity test.