首页|2020-2022年某院呼吸机相关性肺炎病原菌分布特征及耐药性变迁

2020-2022年某院呼吸机相关性肺炎病原菌分布特征及耐药性变迁

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目的:探究 2020-2022 年鹰潭市人民医院呼吸机相关性肺炎病原菌分布特征及耐药性变迁.方法:选取本院 2020 年 1 月—2022 年 12 月收治的 80 例呼吸机相关性肺炎患者的病历资料进行回顾性分析.所有患者均于入院 24 h内采集痰样本进行病原学培养及药敏试验,分析病原菌分布特征并对 3 年内主要感染病原菌的耐药率变化进行分析.结果:80 例痰标本中共检出病原菌 126 株,其中革兰阴性菌 96株(76.19%)、革兰阳性菌 22 株(17.46%)、真菌 8 株(6.35%),鲍曼不动杆菌(29.37%)、肺炎克雷伯菌(19.05%)、铜绿假单胞菌(17.46%)占比较高.鲍曼不动杆菌耐药性分析结果显示,鲍曼不动杆菌对氨曲南、头孢替坦的耐药性较高,对复方新诺明的耐药性较低;不同年份鲍曼不动杆菌各抗生素耐药率比较,差异均无统计学意义(P>0.05).肺炎克雷伯菌耐药性分析结果显示,肺炎克雷伯菌对头孢哌酮舒巴坦钠、氨曲南的耐药性较高,各年份均≥50.00%,对阿米卡星、左氧氟沙星的耐药性较低,各年份均<15.00%;2020-2022 年肺炎克雷伯菌对氨曲南的耐药率呈升高趋势,差异有统计学意义(P<0.05).铜绿假单胞菌耐药性分析结果显示,铜绿假单胞菌对头孢替坦、亚胺培南、左氧氟沙星的耐药性较高,对哌拉西林钠他唑巴坦钠、复方新诺明的耐药性较低.不同年份铜绿假单胞菌各抗生素耐药率比较,差异均无统计学意义(P>0.05).结论:呼吸机相关性肺炎病原菌分布中以鲍曼不动杆菌、肺炎克雷伯菌、铜绿假单胞菌等革兰阴性菌为主,对多种抗菌药均存在不同程度的耐药,且肺炎克雷伯菌对氨曲南的耐药率表现出升高趋势.
Distribution Characteristics and Drug Resistance Changes of Pathogenic Bacteria in Ventilator-associated Pneumonia in A Hospital from 2020 to 2022
Objective:To explore the distribution characteristics and drug resistance changes of pathogenic bacteria in ventilator-associated pneumonia in Yingtan City People's Hospital from 2020 to 2022.Method:The medical records of 80 patients with ventilator-associated pneumonia admitted to our hospital from January 2020 to December 2022 were retrospectively analyzed.Sputum samples of all patients were collected within 24 h of admission for etiological culture and drug susceptible test.The distribution characteristics of pathogenic bacteria and the change of drug resistance rate of major pathogenic bacteria in 3 years were analyzed.Result:A total of 126 strains of pathogenic bacteria were detected in 80 sputum samples,including 96 strains(76.19%)of Gram negative bacteria,22 strains(17.46%)of Gram positive bacteria and 8 strains(6.35%)of fungus.Acinetobacter baumanii(29.37%),Klebsiella pneumoniae(19.05%),Pseudomonas aeruginosa(17.46%)accounted for the higher proportion.The drug resistance analysis of Acinetobacter baumanii showed that the resistance of Acinetobacter baumanii to Aztreonam and Cefotetan were higher,and the resistance of Compound Sulfamethoxazole was lower.There were no significant differences in resistance rates of each antibiotic of Acinetobacter baumanii in different years(P>0.05).The drug resistance analysis of Klebsiella pneumoniae showed that the drug resistance of Klebsiella pneumoniae to Cefoperazone Sulbactam Sodium and Aztreonam were higher,≥50.00%in each year,and the resistance of Aztreonam and Levofloxacin were lower,<15.00%in each year.The resistance rates of Klebsiella pneumoniae to Aztreonam showed an increasing trend from 2020 to 2022,the difference was statistically significant(P<0.05).The drug resistance analysis of Pseudomonas aeruginosa showed that the drug resistance of Pseudomonas aeruginosa to Cefotetan,Imipenem and Levofloxacin were higher,and the resistance of Piperacillin Sodium Tazobactam Sodium and Compound Sulfamethoxazole were lower.There were no significant differences in resistance rates of each antibiotic of Pseudomonas aeruginosa in different years(P>0.05).Conclusion:In the distribution of pathogenic bacteria of ventilator-associated pneumonia,Acinetobacter baumanii,Klebsiella Pneumoniae,pseudomonas aeruginosa and other Gram negative bacteria are the main bacteria,which have different degrees of drug resistance to various antimicrobial agent,and the resistance rate of Klebsiella pneumoniae to Aztreonam shows an increasing trend.

Ventilator-associated pneumoniaPathogenic bacteriaDrug resistance

刘瑞英、陈锐

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鹰潭市人民医院急诊科 江西 鹰潭 335000

呼吸机相关性肺炎 病原菌 耐药性

2024

中国医学创新
中国保健协会

中国医学创新

影响因子:1.706
ISSN:1674-4985
年,卷(期):2024.21(24)