多重耐药菌的科室分布及耐药性

Analysison the distribution and drug resistance of multidrug resistant bacteria in different departments

目的 探讨湖南省职业病防治院(以下简称“我院”)常见的多重耐药菌的临床科室分布及耐药性,降低多重耐药菌在我院的发生率并帮助临床合理用药。方法 采用回顾性分析,选取我院2020年1月至2022年1月的27 420例临床送检标本中的多重耐药菌检出报告数据及多重耐药菌的药敏结果数据,分析我院多重耐药菌的科室分布及耐药性。结果 27 420例送检标本中,检出菌株数5 482例,其中多重耐药菌1 871例,检出量排在前5位的分别是大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、金黄色葡萄球菌。多重耐药菌多分布在骨科、乳甲外科、内科和ICU。药敏结果显示,金黄色葡萄球菌对糖肽类、环脂类和四环素类药物极度敏感,对喹诺酮类和氨基糖苷类药物的相对敏感。大肠埃希菌对甘氨酰环素类极度敏感,对碳青霉烯类药物、氨基糖苷类以及硝基呋喃衍生物的相对敏感,对青霉素类、头孢菌素类药物有较高的耐药性。鲍曼不动杆菌对多黏菌素类敏感度极高,对青霉素类、头孢菌素类和酰胺醇类药物有较高的耐药性。结论 我院多重耐药菌多为革兰氏阴性杆菌,一旦发生感染,尽快获取培养及药敏结果指导临床医生科学用药,同时落实多重耐药菌感染控制标准化流程和处置措施,使多重耐药菌的防控工作更加科学、规范、合理。

Objective To explore the distribution of clinical departments and drug sensitivity analysis of common multidrug resistant bacteria in Hunan Occupational Disease Prevention and Treatment Hospital(hereinafter referred as “our hospital”),so as to reduce the incidence of multidrug resistant bacteria in our hospital and help the clinical departments with rational use of medicine.Method This study applies the method of retrospective analysis.The data of tested-positive multi drug resistant bacteria,and the test results of drug sensitivity against multi drug resistant bacteria were from 27 420 clinical samples collected between Jan 2020 and Jan 2022 in our hospital.The data were selected to analyze the distribution of different departments and drug resistance results of multidrug resistant bacteria in our hospital.Results Among the tested 27 420 samples,5 482 strains were detected,of which 1 871 were multidrug resistant bacteria.The top 5 strains were Escherichia coli,Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus.Multidrug resistant bacteria were mainly distributed in the departments of Orthopedic Surgery,Breast Thyroid Surgery,Internal Medicine and ICU.The results showed:Staphylococcus aureus was extremely sensitive to glycopeptides,cyclolipids and tetracyclines,and relatively sensitive to quinolones and aminoglycosides.Escherichia coli was extremely sensitive to glycylcyclines,relatively sensitive to carbapenems,aminoglycosides and nitrofuran derivatives,and highly resistant to penicillins and cephalosporins.Acinetobacter baumannii was extremely sensitive to polymyxins,but highly resistant to penicillins,cephalosporins and amidoalcohols.Conclusion At present,most of the multidrug resistant bacteria in our hospital are Gram-negative Bacilli.Once an infection occurs,the drug sensitivity results should be obtained as soon as possible to guide clinicians to scientifically prescribe medicine.Meanwhile,standardized control procedures and management measures of multidrug resistant bacteria should be implemented to make the prevention and control measures of multidrug resistant bacteria more scientific,standardized and rational.