2019—2021年新郑市某三级医院病原菌分布及耐药现状分析

Distribution and multidrug-resistance of pathogenic bacteria in a first-class hospital in Xinzheng City from 2019 to 2021

目的研究新郑市某三级医院近3年患者的病原菌分布和耐药性特点,为临床治疗及遏制多耐菌提供科学依据。方法收集2019—2021年新郑市公立人民医院收治的18430例患者的病原菌及药敏数据,分析病原菌分布、科室检出率、药物敏感程度,使用SPSS26.0软件进行统计分析。结果3年间分离出病原菌1948株。检出大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、屎肠球菌最多。多重耐药菌622株,占病原菌的33.93%。前五位耐药菌分别是大肠埃希菌(315株,50.64%)、肺炎克雷伯菌(116株,18.65%)、金黄色葡萄球菌(94株,15.11%)、铜绿假单胞菌(39株,6.27%)、鲍曼不动杆菌(18株,2.89%)。大肠埃希菌对头孢噻肟(53.82%)、环丙沙星(56.48%)、复方新诺明(62.29%)、左氧氟沙星(56.48%)等药耐药率高,对亚胺培南(1.99%)、美罗培南(1.99%)、哌拉西林/他唑巴坦(5.15%)耐药率极低。鲍曼不动杆菌耐药率较高,仅对复方新诺明(19.30%)、左氧氟沙星(21.05%)敏感。金黄色葡萄球菌对青霉素全耐药(100.00%),对阿奇霉素(74.02%)、红霉素(74.02%)、克林霉素(70.10%)耐药率高。未见对替考拉宁、利奈唑胺、万古霉素耐药。结论初步掌握新郑市患者病原菌分布基础数据,为临床医生选药、用药提供科学依据,避免耐药菌的产生。

Objective To study the distribution and drug resistance characteristics of pathogenic bacteria in pa-tients of a first-class hospital in Xinzheng City in the past three years,and to provide scientific basis for clinical treat-ment and control of multidrug-resistant bacteria.Methods The pathogenic bacteria and drug sensitivity data of 18430 patients in the Xinzheng Public People's Hospital from 2019 to 2021 were collected,and the distribution of pathogenic bacteria,department detection rate,and drug sensitivity were analyzed.SPSS26.0 software was used for statistical analy-sis.Results In 3 years,1948 strains of pathogenic bacteria were isolated.Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa,and Enterococcus faecalis were the most detected.There were 622 strains of multidrug-resistant bacteria,accounting for 33.93%of the pathogenic bacteria.The top five multidrug-resistant bac-teria were Escherichia coli(315 strains,50.64%),Klebsiella pneumoniae(116 strains,18.65%),Staphylococcus aureus(94 strains,15.11%),Pseudomonas aeruginosa(39 strains,6.27%),and Acinetobacter baumannii(18 strains,2.89%).The drug resistance rate of Escherichia coli to cefotaxime(53.82%),ciprofloxacin(56.48%),cotrimoxazole(62.29%),levo-floxacin(56.48%)was high,but the drug resistance rate to imipenem(1.99%),meropenem(1.99%),piperacillin/tazobac-tam(5.15%)was very low.The drug resistance rate of Acinetobacter baumannii was high,and it was only sensitive to co-trimoxazole(19.30%)and levofloxacin(21.05%).Staphylococcus aureus had high resistance to penicillin(100.00%),azithromycin(74.02%),erythromycin(74.02%),and clindamycin(70.10%).No resistance were found to teicolanine,li-nezolid or vancomycin.Conclusion The basic data of pathogenic bacterial infection in patients in Xinzheng City were preliminarily obtained,which provided scientific basis for clinicians to choose and use drugs to avoid the generation of drug-resistant bacteria.