摘要
目的 分析2019~2021年呼吸内科多重耐药菌(multidrug resistant organism,MDRO)分布特点及耐药性。方法 选择2019年1月至2021年12月于南昌三三四医院治疗的80例下呼吸道感染患者。采集患者的清晨痰液、尿液、血液及动静脉导管端等标本,采用细菌鉴定仪及药敏分析系统进行菌种鉴定、药敏试验。分析呼吸内科MDRO的分布特点、来源构成及耐药性。结果 80例呼吸内科患者中共检出病原菌167株,其中MDRO 94株,包括鲍曼不动杆菌(Acinetobacter baumanii,Aba)46株(48.94%),铜绿假单胞菌(Pseudomonas aeruginosa,PA)15株(15.96%),肺炎克雷伯菌(Klebsiella pneumoniae,Kpn)27株(28.72%),大肠埃希菌(Escherichia coli,EC)6株(6.38%);肺炎患者中检出MDRO60株,占比最高达63.83%;慢性阻塞性肺疾病患者中检出28株(29.79%);支气管扩张患者中检出4株(4.26%);肺部恶性肿瘤患者中检出2株(2.13%);Aba、PA、Kpn、EC对常用抗生素的耐药率均较高,其中Aba对亚胺培南、美罗培南耐药率高达100%;PA对头孢他啶、哌拉西林、环丙沙星、左氧氟沙星耐药率高;Kpn对哌拉西林/他唑巴坦、头孢哌酮、左氧氟沙星、美罗培南耐药率高;EC对头孢曲松、左氧氟沙星、氨苄西林、美罗培南耐药率高。结论 2019~2021年呼吸内科MDRO感染严重,Aba、PA、Kpn是呼吸内科MDRO感染的主要致病菌,部分细菌对碳青霉烯类药物的耐药性日趋严重,需引起重视。临床在治疗感染性疾病时应根据患者的临床症状、实验室指标及药敏结果等,正确选择抗菌药物。
Objective To analyze the distribution characteristics and drug resistance of multidrug resistant organism(MDRO) in respiratory medicine from 2019 to 2021. Methods Eighty patients with lower respiratory tract infection treated in Nanchang No.334 Hospital from January 2019 to December 2021 were selected. Samples of sputum, urine,blood and arteriovenous catheter were collected from patients in the morning, and bacterial identification and drug sensitivity test were carried out by bacterial identification instrument and drug sensitivity analysis system. The distribution, origin, composition and drug resistance of MDRO in respiratory medicine were analyzed. Results A total of 167 strains of pathogenic bacteria were detected in 80 patients with respiratory medicine. Among them, 94 strains of MDRO, including 46 strains of Acinetobacter baumanii(Aba)(48.94%), 15 strains of Pseudomonas aeruginosa(PA)(15.96%), 27 strains of Klebsiella pneumoniae(Kpn)(28.72%) and 6 strains of Escherichia coli(EC)(6.38%) were detected. 60 MDRO strains were detected from pneumonia patients, accounting for the highest proportion of 63.83%.28 strains(29.79%) were detected from patients with chronic obstructive pulmonary disease. 4 strains(4.26%) were detected from patients with bronchiectasis. Two strains(2.13%) were detected from patients with lung malignant tumor. Aba, PA, Kpn, EC had high resistance rate to common antibiotics, and the resistance rate of Aba to imipenem and meropenem was 100%. The resistance rate of PA to ceftazidime, piperacillin, ciprofloxacin and levofloxacin was high;Kpn had high resistance to piperacillin/tazobactam, cefoperazone, levofloxacin and meropenem. EC had high resistance to ceftriaxone, levofloxacin, ampicillin and meropenem. Conclusion From 2019 to 2021, MDRO infection in the respiratory department was serious. Aba, PA and Kpn were the main pathogenic bacteria of MDRO infection in respiratory medicine. The resistance of some bacteria to carbapenems is becoming more and more serious, which needs to be paid atte
作者
肖芸
XIAO Yun(Department of Pharmacy,Nanchang No.334 Hospital,Nanchang 330024,China)
出处
《中国现代医生》
2022年第28期71-74,共4页
China Modern Doctor
关键词
呼吸内科
多重耐药菌
分布特点
来源构成
耐药性
Respiratory medicine
Multidrug resistant organism
Distribution characteristic
Source composition
Drug resistance
