摘要
目的 通过分析南京某医院2020-2022年大肠埃希菌与肺炎克雷伯菌临床分布及耐药性情况,为临床合理使用抗菌药物提供依据.方法 回顾性分析统计2020-2022年东南大学附属中大医院大肠埃希菌与肺炎克雷伯菌标本分布及耐药性情况.结果 2020-2022年本院共检出病原菌分别为3 507、4 323及4 806株,大肠埃希菌分别为616、748及840株,肺炎克雷伯菌分别为456、631及757株,两种病原菌3年总检出率分别为17.4％和14.6％.2020-2022年病原菌构成比差异有统计学意义(P＜0.01).2020-2022年间,病原菌检出量排前三的标本为痰、血液及尿液.2020-2022年间,大肠埃希菌对头孢吡肟、头孢曲松、头孢唑林、庆大霉素、环丙沙星、左氧氟沙星及复方新诺明的耐药率差异有统计学意义(P＜0.01).肺炎克雷伯菌对亚胺培南、厄他培南、头孢吡肟、头孢曲松、头孢哌酮舒巴坦、头孢唑啉、头孢西丁、哌拉西林他唑巴坦、氨苄西林、阿米卡星、庆大霉素、左氧氟沙星、呋喃妥因及复方新诺明的耐药率差异有统计学意义(P＜0.01).结论 2020-2022年间,大肠埃希菌与肺炎克雷伯菌两者的检出率高达30％以上.大肠埃希菌与肺炎克雷伯菌对多种抗菌药物的耐药性有差异,临床目标性用药需严格按照药敏结果来选择.
Abstract
Objective The clinical distribution and drug resistance of Escherichia coli and Klebsiella pneumoniae in a hospital of Nanjing from 2020 to 2022 were analyzed in order to provide the basis for clinical rational use of antibiotics.Methods The distribution and drug resistance of Escherichia coli and Klebsiella pneumoniae specimens in Zhongda Hospital Southeast University from 2020 to 2022 were retrospectively analyzed.Results A total of 3 507,4 323 and 4 806 pathogenic bacteria were detected from 2020 to 2022.There were 616,748 and 840 strains of Escherichia coli,and 456,631 and 757 strains of Klebsiella pneumoniae,with the total 3-year detection rate of 17.4％and 14.6％.There was a statistically significant difference in the constituent ratio of pathogenic bacteria between 2020 and 2022(P＜0.01).From 2020 to 2022,the top three samples of pathogenic bacteria were sputum,blood and urine.From 2020 to 2022,the drug resistance rates of Escherichia coli to cefepime,ceftriaxone,cefazolin,gentamicin,ciprofloxacin,levofloxacin and compound trimethoprim were significantly different(P＜0.01).The drug resistance rates of Klebsiella pneumoniae to imipenem,ertapenem,cefepime,ceftriaxone,cefoperazone sulbactam,cefazolin,cefoxitin,piperacillin tazobactam,ampicillin,amikacin,gentamicin,levofloxacin,nitrofurantoin and compound trimethoprim were significantly different(P＜0.01).Conclusion The average detection rate of Escherichia coli and Klebsiella pneumoniae was more than 30％in 2020-2022.The resistance of Escherichia coli and Klebsiella pneumoniae to various antibacterial drugs is statistically different.The clinically targeted drugs need to be selected in strict accordance with the drug sensitivity results.
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