摘要
目的探讨2017—2019年如皋市人民医院感染性疾病病原菌分布及耐药性。方法回顾性分析2017年1月—2019年12月如皋市人民医院院内感染性疾病送检的16834份病原菌标本,详细记录送检科室、感染部位等信息,同时记录不同标本的检测结果,分析病原菌的分布情况及药敏试验结果。结果2017—2019年每年送检样本均以痰液及尿液为主,其中痰液样本量呈逐年上升趋势,其余样本量均呈逐年下降趋势。每年样本送检科室主要为呼吸科、重症监护室及神经外科,其中重症监护室送检样本逐年上升。16834份样本中共检出2272株致病菌,检出率为13.5%;其中革兰阴性菌1450株,占63.8%,以Eco、Kpn、Pae、Aba为主;革兰阳性菌681株,占30.0%,以Sau、Efm、Cns为主;真菌141株,占6.2%,以Cal、Ctr为主。2017—2019年Aba检出率呈逐年上升趋势,Cal检出率呈逐年下降趋势。Eco、Kpn、Pae、Aba对LVX、FEP、CAZ的耐药率均比较高,对TZP的耐药率呈逐年上升趋势;Eco对IMP、MEM均有较好的敏感性,Aba对IMP、MEM的耐药性呈逐年上升趋势。Sau、Efm与Cns对P、E的耐药率均比较高,对VA、LZD、TGC敏感性比较高;3种菌株对LVX、CIP的耐药率呈逐年上升趋势,Sau、Cns对GM的耐药率有逐年下降趋势。Cal、Ctr对4种抗真菌药的敏感性均比较高。结论2017—2019年如皋市人民医院感染性疾病病原菌有变迁,主要为Aba检出率增加,Cal检出率降低,且耐药情况亦有变化,多种病原菌对TZP、IMP、MEM的耐药率明显增加,因此如皋市人民医院耐药性形势严峻,在临床工作中需避免广谱抗菌药物的经验性使用,严格掌握适应症、禁忌证,同时掌握好抗菌药物的降阶梯使用。
Objective To explore the distribution and drug resistance of infectious disease pathogens in Rugao People's Hospital from 2017 to 2019.Methods Retrospective analysis of 16,834 pathogenic bacteria specimens submitted for inspection of infectious diseases in our hospital from January 2017 to December 2019,detailed records of information submitted to inspection departments,infection sites,etc.,while recording the test results of different specimens,and analyzing the distribution of pathogens And the results of drug sensitivity test.Results From 2017 to 2019,sputum and urine are the main samples submitted for inspection each year.The sputum sample volume is increasing year by year,and the remaining sample volume is decreasing year by year.The annual sample inspection departments are mainly respiratory department,intensive care unit and neurosurgery,among which the number of samples submitted to intensive care unit is increasing year by year.A total of 2,272 pathogenic bacteria were detected in 16,834 samples,with a detection rate of 13.5%;of which 1,450 strains of Gram-negative bacteria,accounting for 63.8%,were mainly Eco,Kpn,Pae,and Aba;681 strains of Gram-positive bacteria,Accounting for 30.0%,mainly Sau,Efm,and Cns;141 fungi,accounting for 6.2%,mainly Cal and Ctr.From 2017 to 2019,the detection rate of Aba has been increasing year by year,and the detection rate of Cal has been decreasing year by year.The resistance rates of Eco,Kpn,Pae,and Aba to LVX,FEP,and CAZ are relatively high,and the resistance rate to TZP is increasing year by year;Eco has good sensitivity to IMP and MEM,and Aba to IMP and MEM The drug resistance is increasing year by year.The resistance rates of Sau,Efm and Cns to P and E are relatively high,and the sensitivity to VA and LZD,is relatively high;the resistance rates of the three strains to LVX and CIP are increasing year by year,and Sau and Cns are resistant to GM.The resistance rate has a downward trend year by year.Cal and Ctr have relatively high sensitivity to the four antifungal drugs.
作者
席骏钻
王琳
杨慧
钱辉
汤金燕
沈锦华
XI Junzuan;WANG Lin;YANG Hui;QIAN Hui;TANG Jinyan;SHEN Jinhua(Pharmacy Department,The People’s Hospital of Rugao,Rugao Jiangsu 226500,China;Clinical Laboratory,The People’s Hospital of Rugao,Rugao Jiangsu 226500,China)
出处
《中国实验诊断学》
2023年第7期757-762,共6页
Chinese Journal of Laboratory Diagnosis
基金
江苏省药学会奥赛康临床药学基金科研项目(A201837)
江苏省卫生计生委2017年医学科研课题项目(201719)
关键词
感染性疾病
革兰阴性菌
革兰阳性菌
病原菌
耐药性
infectious diseases
gram-negative bacteria
gram-positive bacteria
pathogenic bacteria
drug resistance
