肺部感染患者碳青霉烯类抗菌药物耐药情况分析

Analysis of Drug Resistance of Carbapenem Antibiotics in Patients with Pulmonary Infection

目的:分析肺部感染患者碳青霉烯类抗菌药物耐药情况,并对肺部感染患者碳青霉烯类抗菌药物应用情况进行合理性评价.方法:选取2018年10月—2021年10月我院收治的102例肺部感染患者作为研究对象,采集患者痰液标本进行细菌培养和药敏试验,分析肺部感染患者碳青霉烯类抗菌药物耐药情况,并评估肺部感染患者碳青霉烯类抗菌药物用药合理情况.结果:102例肺部感染患者送检的标本中共分离出病原菌株204株,其中革兰阴性菌165株,占比为80.88%,主要为铜绿假单胞菌、鲍氏不动杆菌、肺炎克雷伯菌、大肠埃希菌;革兰阳性菌39株,占比为19.12%,主要为金黄色葡萄球菌;金黄色葡萄球菌对亚胺培南、厄他培南的耐药性最高,耐药率分别为73.33%、60.00%;铜绿假单胞菌对美罗培南、厄他培南耐药性最高,耐药率分别为62.07%、55.17%;鲍氏不动杆菌对亚胺培南、比阿培南耐药性最高,耐药率分别为68.42%、63.15%;肺炎克雷伯菌对亚胺培南、厄他培南耐药性最高,耐药率分别为79.31%、75.86%;大肠埃希菌对美罗培南、帕尼培南耐药性最高,耐药率分别为72.72%、63.64%;102例肺部感染患者中,不合理应用碳青霉烯类抗菌药物16例,其中给药剂量不合理6例,给药频率不合理5例,联合用药不合理5例,不合理用药占比为15.69%.结论:肺部感染患者碳青霉烯类抗菌药物的耐药现象较严峻,不合理应用情况较为突出,未来临床可结合药敏试验结果,合理使用碳青霉烯类抗菌药物,以减轻降低细菌对碳青霉烯类抗菌药物的耐药率.

Objective:To analyze the drug resistance of carbapenems in patients with pulmonary infection,and to evaluate the rationality of the use of carbapenems in patients with pulmonary infection.Methods:A total of 102 patients with pulmonary infection admitted to our hospital from October 2018 to October 2021 were selected as the research objects.Sputum samples were collected from patients for bacterial culture and drug sensitivity test.The resistance of carbapenem antibiotics in patients with pulmonary infection was analyzed,and the rational use of carbapenem antibiotics in patients with pulmonary infection was evaluated.Results:A total of 204 pathogenic strains were isolated from the samples of 102 patients with pulmonary infection,including 165 strains of gram-negative bacteria,accounting for 80.88%,mainly Pseudomonas aeruginosa,Acinetobacter baumannii,Klebsiella pneumoniae,and Escherichia coli.39 strains of Gram positive bacteria,accounting for 19.12%,were mainly Staphylococcus aureus.Staphylococcus aureus had the highest resistance to imipenem and ertapenem,and the drug resistance rates were 73.33%and 60.00%respectively.Pseudomonas aeruginosa had the highest resistance to meropenem and ertapenem,with resistance rates of 62.07%and 55.17%respectively.Acinetobacter baumanni had the highest resistance to imipenem and biapenem,with drug resistance rates of 68.42%and 63.15%respectively.Klebsiella pneumoniae had the highest resistance to imipenem and ertapenem,with resistance rates of 79.31%and 75.86%respectively.The resistance of Escherichia coli to meropenem and panipenem was the highest,and the drug resistance rates were 72.72%and 63.64%respectively.Among 102 patients with pulmonary infection,16 cases were unreasonably treated with carbapenem antibiotics,including 6 cases with unreasonable dosage,5 cases with unreasonable frequency of administration,and 5 cases with unreasonable combination of drugs,accounting for 15.69%.Conclusion:The drug resistance of carbapenem antibiotics in patients with pulmonary infection is serious,and the unreasonable application is more prominent.In the future,carbapenem antibiotics can be rationally used in combination with the results of drug sensitivity test to reduce the resistance rate of bacteria to carbapenem antibiotics.