新建医院病原菌分布及耐药性分析

Analysis of Pathogen Distribution and Drug Resistance in Newly Built Hospital

目的:通过分析某新建医院开诊三年的常见病原菌分布及其耐药情况,为同类医院临床提供耐药数据,指导合理使用抗菌药物,并为本地区病原菌分布及耐药情况提供参考数据。方法:回顾性分析2020年5月1日—2023年4月30日某新建医院建院前三年的微生物室标本鉴定及药敏的数据,统计分析标本来源、常见病原菌分布及耐药情况。结果:共分离出2440株病原菌,菌株数位于前五位的依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌和土曲霉,分别占18.40%、14.47%、11.97%、9.30%和6.23%。阳性标本以痰液和分泌物居多,分别占33.40%和30.04%,其次是尿标本和血标本。从尿和血标本中分离培养出的病原菌,大肠埃希菌菌株数最多;从痰标本中分离培养出的病原菌,肺炎克雷伯菌菌株数最多,其次是铜绿假单胞菌;从分泌物标本中分离培养出的病原菌,金黄色葡萄球菌菌株数最多,其次是土曲霉。大肠埃希菌,对氨苄西林、头孢呋辛、头孢呋辛酯、头孢曲松、头孢唑林、左氧氟沙星耐药率较高;对阿米卡星、厄他培南、美罗培南、哌拉西林/他唑巴坦、替加环素、头孢哌酮/舒巴坦、亚胺培南耐药率较低。肺炎克雷伯菌,除头孢唑林外,对其余抗菌药物的耐药率均低于42%。铜绿假单胞菌对阿米卡星、庆大霉素、头孢吡肟、粘菌素的耐药率一直保持在10%以下。鲍曼不动杆菌,对替加环素、粘菌素和米诺环素耐药率较低。金黄色葡萄球菌对替加环素、达托霉素、利福平、万古霉素、替考拉宁、头孢洛林、米诺环素耐药率均为0。结论:某院建院三年来,共分离出2440株病原菌,阳性标本以痰液和分泌物居多,微生物室应及时准确地为临床医生提供病原菌鉴定及药敏结果,为临床合理选择抗菌药物治疗方案提供理论基础,降低耐药率。

Objective:To analyze the distribution and drug resistance of common pathogens in a newly built hospital in the past three years,so as to provide drug resistance data for similar hospitals,guide the rational use of antibiotics,and provide reference data for the distribution and drug resistance of pathogens in the region.Methods:The data of microbiology room specimen identification and drug susceptibility in a newly built hospital three years before its establishment(from May 1,2020 to April 30,2023)were retrospectively analyzed.The source of specimens,distribution of common pathogens and drug resistance were statistically analyzed.Results:A total of 2440 isolates were isolated.The top five strains were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Pseudomonas aeruginosa and Aspergillus terreus,accounting for 18.40%,14.47%,11.97%,9.30%and 6.23%,respectively.Sputum and secretions accounted for 33.40%and 30.04%respectively,followed by urine and blood samples.The number of pathogenic bacteria isolated from urine and blood samples was the largest.Among the pathogens isolated from sputum samples,Klebsiella pneumoniae had the largest number of strains,followed by Pseudomonas aeruginosa.Staphylococcus aureus was the most common pathogen isolated from secretions,followed by Aspergillus terreus.Escherichiae coli had higher resistance rate to ampicillin,cefuroxime,cefuroxime axetil,ceftriaxone,cefzolin and levofloxacin.The resistance rate to amikacin,ertapenem,meropenem,piperacillin/tazobactam,tigacycline,cefoperazone/sulbactam,and imipenem was low.The resistance rate of Klebsiella pneumoniae to other antibiotics except cefazolin was lower than 42%.The resistance rate of Pseudomonas aeruginosa to amikacin,gentamicin,cefepime and colistin remained below 10%.Acinetobacter baumannii showed low resistance to tigacycline,colistin and minocycline.The drug resistance rate of Staphylococcus aureus to tigacycline,daptomycin,rifampicin,vancomycin,teicolanin,cefalorin and minocycline were 0.Conclusion:In the three years since the establishment of a hospital,a total of 2440 strains of pathogenic bacteria were isolated.The positive samples were mostly sputum and secretions.The microbiology room should provide timely and accurate pathogen identification and drug sensitivity results for clinicians.It can provide theoretical basis for rational selection of antimicrobial therapy,and reduce drug resistance rate.