2021—2023年海南某院急诊科细菌分离情况及耐药监测数据分析

Bacterial isolation and drug resistance monitoring data in the Emergency Department of a hospital in Hainan from 2021 to 2023

目的了解急诊科分离病原菌的分布及耐药情况,为急诊科感染性患者的诊疗提供依据。方法应用WHONET 5.6对2021—2023年海南省人民医院急诊科患者分离细菌及药敏结果数据进行分析。结果2021—2023年急诊科共分离细菌1149株,2021年分离株数最多,共486株,2022年分离株数最少,共304株,革兰阳性菌占比25.9%~33.2%,三年间大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌、铜绿假单胞菌和金黄色葡萄球菌是分离最多的细菌,分别为209株、156株、139株、131株和80株;血和痰是分离细菌最多的标本,三年间共分别分离出498株和354株细菌,患者性别男性多于女性,61~80岁组是分离细菌最多的年龄分组。2021年甲氧西林耐药金黄色葡萄球菌占比最高,达42.3%,对碳青霉烯类药物耐药的大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌则在2023年最高,对亚胺培南的耐药率分别为2.7%、3.6%和43.2%,碳青霉烯耐药鲍曼不动杆菌在2021年检出率最高,对亚胺培南和美罗培南的耐药率分别为80.5%和87.8%。结论急诊科分离菌以鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌最多,2021—2023年分离菌对药物的耐药未出现明显趋势,可根据细菌监测分析报告考虑可能的病原,依据耐药监测结果进行经验性用药。

Objective To understand the distribution and drug resistance of pathogens isolated from the Emer-gency Department,and to provide a basis for the diagnosis and treatment of patients with infectious diseases in the Emer-gency Department.Methods WHONET 5.6 was used to analyze the data of bacterial isolation and drug susceptibility results of patients in the Emergency Department of Hannan General Hospital from 2021 to 2023.Results A total of 1149 strains of bacteria were isolated in the Emergency Department from 2021 to 2023,with the highest number of iso-lates in 2021(486 strains)and the lowest in 2022(304 strains).Gram-positive bacteria accounted for 25.9%to 33.2%of the total isolates.Escherichia coli(209 strains),Klebsiella pneumoniae(156 strains),Acinetobacter baumannii(139 strains),Pseudomonas aeruginosa(131 strains),and Staphylococcus aureus(80 strains)were the most frequently isolated bacteria in the three years.Blood and sputum were the most common specimens for bacterial isolation,from which the number of strains isolated among the three years were 498 and 354,respectively.And male patients were more than female patients.The age group of 61-80 years had the highest number of isolated bacteria.The proportion of methicillin-resistant Staphy-lococcus aureus was highest in 2021,reaching 42.3%.Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aerugino-sa showed the highest resistance to carbapenems in 2023,and their resistance rate to imipenem were 2.7%,3.6%,and 43.2%,respectively.Carbapenem-resistant Acinetobacter baumannii had the highest detection rate in 2021,and its resis-tance rate to imipenem and meropenem was 80.5%and 87.8%,respectively.Conclusion Acinetobacter baumannii,Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and Staphylococcus aureus were the most commonly iso-lated bacteria in the Emergency Department.There was no significant trend in drug resistance of isolated bacteria from 2021 to 2023.Possible pathogens can be considered based on bacterial surveillance reports,and clinical doctors can choose empirical antibiotic medication according to the drug resistance monitoring data.