北京市平谷区医院的感染性疾病病原菌分布及耐药性

张　鑫; 陈华伟; 徐云雷; 王慧敏; 李伟健; 熊凤国; 刘玉英

文章摘要

北京市平谷区医院的感染性疾病病原菌分布及耐药性

Distribution and drug resistance of infectious disease pathogens in Beijing Pinggu Hospital

DOI：10.3969/j.issn.1007-8134.2020.06.017

中文关键词: 感染性疾病病原菌耐药性

英文关键词: infectious disease pathogenic bacteria drug resistance

基金项目:

作者	单位
张　鑫	北京市平谷区医院感染疾病科
陈华伟	北京市平谷区医院感染疾病科
徐云雷	北京市平谷区医院感染疾病科
王慧敏	北京市平谷区医院感染疾病科
李伟健	北京市平谷区医院感染疾病科
熊凤国	北京市平谷区医院感染疾病科
刘玉英	北京市平谷区医院感染疾病科

摘要点击次数: 674

全文下载次数: 419

中文摘要:

目的　分析北京市平谷区医院近3年收治的感染性疾病患者的病原菌分布及耐药性，以指导临床抗生素使用。方法　收集2016年1月—2018年12月在北京市平谷区医院就诊的感染性疾病患者的血液、痰液、尿液等标本共24 283例，均行病原菌培养和药物敏感（药敏）试验，分析感染病原菌构成、耐药菌情况及药敏试验结果。结果　2016年、2017年、2018年感染性疾病患者感染革兰阴性菌、革兰阳性菌、真菌的构成比例差异无统计学意义（P＞0.05）。2016年、2017年、2018年分离的产超广谱β-内酰胺酶（extended spectrum β-lactamase, ESBLs）大肠埃希菌分别占大肠埃希菌的40.85%、39.93%、37.41%，分离的产ESBLs肺炎克雷伯菌分别占肺炎克雷伯菌的23.70%、23.53%、25.93%，差异均无统计学意义（P均＞0.05）。2016年、2017年、2018年分离的耐甲氧西林金黄色葡萄球菌占金黄色葡萄球菌的54.35%、46.64%、31.27%，耐甲氧西林凝固酶阴性葡萄球菌占凝固酶阴性葡萄球菌的62.00%、54.66%、48.51%，差异均有统计学意义（P均＜0.05）。革兰阴性菌中大肠埃希菌对氨曲南、头孢吡肟、头孢哌酮、美罗培南、亚胺培南高度敏感；铜绿假单胞菌对头孢吡肟、头孢哌酮、美罗培南、亚胺培南高度敏感；肺炎克雷伯菌对头孢哌酮、美罗培南、阿米卡星高度敏感；鲍曼不动杆菌对头孢吡肟、头孢哌酮、阿米卡星高度敏感。主要革兰阳性菌中金黄色葡萄球菌、表皮葡萄球菌均对万古霉素、替考拉宁、利奈唑胺高度敏感，耐药率均为0。结论　北京市平谷区医院近3年感染性疾病病原菌构成无明显变化。革兰阴性菌耐药率稳中有降，革兰阳性菌耐药率下降显著，说明抗生素滥用在一定程度上得到控制，但病原菌耐药表型检出率仍较高。

英文摘要:

Objective　To analyze the distribution and drug resistance of pathogenic bacteria of infectious diseases in Beijing Pinggu Hospital in recent 3 years, so as to guide the clinical use of antibiotics. Methods　A total of 24 283 samples of blood, sputum and urine from patients with infectious diseases in Beijing Pinggu Hospital from January 2016 to December 2018 were collected. All samples were cultured for pathogenic bacteria and tested for drug sensitivity. The composition of pathogenic bacteria, drug resistance and drug sensitivity test results were analyzed. Results　There was no statistically significant difference in the proportions of Gram-negative bacteria, Gram-positive bacteria and fungi in infectious disease patients in 2016, 2017, and 2018 (P＞0.05). The extended-spectrum β-lactamase (ESBLs)-producing Escherichia coli isolated in 2016, 2017, and 2018 accounted for 40.85%, 39.93% and 37.41% of Escherichia coli, respectively. The isolated ESBLs-producing Klebsiella pneumoniae accounted for 23.70%, 23.53%, 25.93% of Klebsiella pneumoniae, respectively, and the difference was not statistically significant (P＞0.05). Methicillin-resistant Staphylococcus aureus isolated in 2016, 2017, and 2018 accounted for 54.35%, 46.64% and 31.27% of Staphylococcus aureus, and methicillin-resistant coagulase-negative Staphylococci accounted for 62.00%, 54.66% and 48.51% of coagulase-negative Staphylococci, with statistically significant difference (P＜0.05). Among the Gram-negative bacteria, Escherichia coli were highly sensitive to aztreonam, cefepime, cefoperazone, meropenem and imipenem. Pseudomonas aeruginosa were highly sensitive to cefepime, cefoperazone, meropenem and imipenem. Klebsiella pneumoniae were highly sensitive to cefoperazone, meropenem and amikacin. Acinetobacter baumannii were highly sensitive to cefepime, cefoperazone and amikacin. Among the main Gram-positive bacteria robs, Staphylococcus aureus and Staphylococcus epidermidis were highly sensitive to vancomycin, teicoplanin and linezolid, and the resistance rates were all 0. Conclusions　The composition of pathogenic bacteria of infectious diseases in Beijing Pinggu Hospital is not changed significantly in the past 3 years. The drug resistance of Gram-negative bacteria is stable and decreased, while that of Gram-positive bacteria is significantly decreased, indicating that the abuse of antibiotics is controlled to a certain extent, but the detection rate of drug-resistant phenotypes of pathogenic bacteria is still high.

HTML 查看全文下载PDF阅读器

关闭