宜春市第二人民医院住院患者多重耐药菌分布特点及其耐药性分析

Analysis of Distribution Characteristics and Drug Resistance of Multi Drug Resistant Bacteria in Inpatients of Yichun Second People's Hospital

目的:探究宜春市第二人民医院住院患者多重耐药菌分布特点及其耐药性。方法:回顾性分析2019年8月-2021年12月宜春市第二人民医院的120例住院患者的临床资料,对尿液、痰液、血液、穿刺液、胸腹水、粪便等标本行病原微生物检测及药敏试验。分析多重耐药菌菌株分离情况;分析多重耐药菌标本来源及构成比;分析多重耐药菌在抗菌药物中的耐药性。结果:120例住院患者中共分离出细菌440株,检出多重耐药菌46株,检出率为10.45%(46/440)。多重耐药菌标本分别源于痰液、尿液、分泌物、血液、肺泡灌洗液和其他,其中痰液标本检出多重耐药菌最多为28株,检出率为60.87%(28/46),其次为肺泡灌洗液(5株)及尿液(4株),检出率分别为10.87%(5/46)、8.70%(4/46)。碳青霉素烯类耐药铜绿假单胞菌(CR-PAE)对环丙沙星耐药性较高,耐药率为61.54%。碳青霉素烯类耐药鲍曼不动杆菌(CR-ABA)对头孢他啶、头孢曲松、亚胺培南、头孢吡肟、环丙沙星、庆大霉素、妥布霉素耐药性较高,耐药率分别为100.00%、91.67%、91.67%、83.33%、83.33%、83.33%、83.33%。碳青霉素烯类耐药肺炎克雷伯菌(CR-KPN)对环丙沙星、复方磺胺甲噁唑钠、舒巴坦、克拉维酸、头孢唑啉、左氧氟沙星、头孢曲松钠、厄他培南、头孢西丁、氨曲南、亚胺培南、头孢吡肟、他唑巴坦、头孢他啶、庆大霉素耐药性较高,耐药率≥80.00%。耐甲氧西林金黄色葡萄球菌(MRSA)对青霉素、苯甲异噁唑青霉素、红霉素耐药性较高,耐药率分别为85.71%、85.71%、71.43%。结论:宜春市第二人民医院住院患者多重耐药菌检出率较高,在临床上需加强多重耐药菌耐药性的测定,有助于更好的使用抗菌药物,避免多重耐药菌感染的蔓延。

Objective:To explore the distribution characteristics and drug resistance of multi-drug resistant bacteria in the inpatients of Yichun Second People's Hospital.Method:Clinical data of 120 inpatients admitted to the Yichun Second People's Hospital from August 2019 to December 2021 were retrospectively analyzed.Pathogenic microorganisms were detected and drug sensitivity tests were performed on urine,sputum,blood,puncture fluid,thorax and abdominal fluid,stool and other samples.The isolation of multi-drug resistant bacteria was analyzed;the source and composition ratio of multi-drug resistant bacteria were analyzed;the resistance of multi-drug resistant bacteria in antibiotics were analyzed.Result:A total of 440 strains of bacteria were isolated from 120 inpatients,and 46 strains of multi-drug resistant bacteria were detected,with a detection rate of 10.45%(46/440).The multidrug resistant bacteria samples were respectively from sputum,urine,secretion,blood,and alveolar lavage fluid and others,the sputum samples detected 28 strains of multi-drug resistant bacteria at most,with a detection rate of 60.87%(28/46),followed by alveolar lavage fluid(5 strains)and urine(4 strains),with a detection rate of 10.87%(5/46)and 8.70%(4/46),respectively.Carbapenem resistant Pseudomonas aeruginosa(CR-PAE)has a high resistance to Ciprofloxacin,with a resistance rate of 61.54%.Carbapenem resistant Acinetobacter baumannii(CR-ABA)were highly resistant to Ceftazidime,Ceftriaxone,Imipenem,Cefepime,Ciprofloxacin,Gentamycin and Tobramycin,with resistance rates of 100.00%,91.67%,91.67%,83.33%,83.33%,83.33%and 83.33%respectively.Carbapenem resistant Klebsiella pneumoniae(CR-KPN)were highly resistant to Ciprofloxacin,Compound Sulfamethoxazole Sodium,Sulbactam,Clavulanic Acid,Cefazolin,Levofloxacin,Ceftriaxone Sodium,Ertapenem,Cefoxitin,Aztreonam,Imipenem,Cefepime,Tazobactam,Ceftazidime,Gentamycin,and the drug resistance rate were≥80.00%.Methicillin resistant Staphylococcus aureus(MRSA)were highly resistant to Penicillin,Anisoxacillin and Erythromycin,and the drug resistance rates were 85.71%,85.71%and 71.43%respectively.Conclusion:The detection rate of multi-drug resistant bacteria in the inpatients of Yichun Second People's Hospital is relatively high.It is necessary to strengthen the determination of multi-drug resistant bacteria in clinical practice,which is helpful to better use antibiotics and avoid the spread of multi-drug resistant bacteria infection.