实用检验医师杂志2024，Vol.16Issue(3) ：201-205.DOI:10.3969/j.issn.1674-7151.2024.03.003

某医院重症医学科2020-2022年住院患者病原学及耐药情况分析

Analysis on etiology and drug resistance of hospitalized patients in intensive care unit of a hospital from 2020 to 2022

汤湖波 陈静 左小淑
实用检验医师杂志2024，Vol.16Issue(3) ：201-205.DOI:10.3969/j.issn.1674-7151.2024.03.003
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某医院重症医学科2020-2022年住院患者病原学及耐药情况分析

Analysis on etiology and drug resistance of hospitalized patients in intensive care unit of a hospital from 2020 to 2022

汤湖波 1陈静 2左小淑3
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作者信息

  • 1. 443413 湖北宜昌,五峰土家族自治县人民医院重症医学科
  • 2. 443413 湖北宜昌,五峰土家族自治县人民医院重症医学科;430060 湖北武汉,武汉大学人民医院急诊科
  • 3. 443413 湖北宜昌,五峰土家族自治县人民医院重症医学科;430060 湖北武汉,武汉大学人民医院重症医学科
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摘要

目的 分析某医院 2020-2022 年重症医学科(ICU)住院患者主要病原菌分布及耐药情况.方法 回顾并分析 2020 年 1 月—2022 年 12 月五峰土家族自治县人民医院ICU送检标本的细菌鉴定和药敏试验结果,分析主要病原菌构成及耐药情况.结果 2020-2022年ICU送检标本共检出非重复临床分离株 262 株,其中肺炎克雷伯菌占比最高(54 株,占 20.61%),其次分别为大肠埃希菌 35 株(占 13.36%),金黄色葡萄球菌 26 株(占 10.00%),铜绿假单胞菌 19 株(占 7.25%),流感嗜血杆菌 15 株(占 5.73%),鲍曼不动杆菌 13 株(占 4.96%),其他 70 株(占 26.72%).肺炎克雷伯菌对碳青霉烯类药物的耐药率为 13.33%,对头孢菌素类和氨基糖苷类的耐药率为 15%～20%,而对喹诺酮类的耐药率为 13.64%;大肠埃希菌对头孢菌素类药物的耐药率为 30%～50%,对氨基糖苷类的耐药率为 10%～30%,对喹诺酮类的耐药率为 37.93%;铜绿假单胞菌对头孢他啶的耐药率高达 80.00%,对哌拉西林及哌拉西林/他唑巴坦的耐药率为 10%～20%,对亚胺培南及美罗培南的耐药率分别为 13.33%、20.00%;流感嗜血杆菌对哌拉西林的耐药率高达 13.33%;鲍曼不动杆菌对碳青霉烯类药物的耐药率为 81.82%.此外,金黄色葡萄球菌对青霉素的耐药率为 100.00%,对苯唑西林的耐药率为 21.70%.结论 ICU分离出的细菌仍以革兰阴性(G-)菌为主,尤其是肺炎克雷伯菌和大肠埃希菌,面临的耐药形势较严峻,定期监测ICU主要病原菌的构成及其耐药谱的变化对于指导合理使用抗菌药物具有重要意义.

Abstract

Objective To analyze the distribution and drug resistance of major pathogens among hospitalized patients in intensive care unit(ICU)from January 2020 to December 2022.Methods A retrospective analysis was conducted on bacteria identification and drug sensitivity results of specimens submitted to ICU of Wufeng Tujia Autonomous County People's Hospital.The composition and drug resistance of the main pathogens were analyzed.Results From 2020 to 2022,a total of 262 non duplicated clinical isolates were detected from ICU specimens.Among them,Klebsiella pneumoniae had the highest proportion(54 strains,accounting for 20.61%),followed by Escherichia coli(35 strains,13.36%),Staphylococcus aureus(26 strains,10.00%),Pseudomonas aeruginosa(19 strains,7.25%),Haemophilus influenzae(15 strains,5.73%),Acinetobacter baumannii(13 strains,4.96%)and others(70 strains,26.72%).Klebsiella pneumoniae had resistance rate of 13.33%to carbapenems,with resistance rates to cephalosporins and aminoglycosides ranging of 15%-20%,and a resistance rate of 13.64%to quinolones.Escherichia coli showed a resistance rate of 30%-50%to cephalosporins,10%-30%to aminoglycosides,and 37.93%to quinolones.Pseudomonas aeruginosa exhibited a high resistance rate of 80.00%to ceftazidime,with resistance rates of 10%-20%to piperacillin and piperacillin/tazobactam,and resistance rates of 13.33%and 20.00%to imipenem and meropenem.Haemophilus influenzae had a resistance rate of 13.33%to piperacillin,while Acinetobacter baumannii showed resistance rate of 81.82%to carbapenems.Additionally,Staphylococcus aureus had resistance rate of 100.00%to penicillin and 21.70%to oxacillin.Conclusions The bacteria isolated from ICU are still predominantly Gram negative(G-)bacteria,with Klebsiella pneumoniae and Escherichia coli being the most common.The resistance situation is severe.Regular monitoring of the main bacterial composition and resistance patterns in ICU is crucial for guiding the rational use of antibiotics.

关键词

病原学/重症医学科/细菌/耐药

Key words

Etiology/Intensive care unit/Bacterium/Drug resistance

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基金项目

中央高校基本科研业务费专项(2042022kf1096)

出版年

2024
实用检验医师杂志
中国医师协会 天津市天津医院

实用检验医师杂志

影响因子：0.297
ISSN：1674-7151
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