2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性分析
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摘要
目的分析2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性,为临床抗菌药物的合理应用提供依据。方法回顾性分析2014—2018年天津市宝坻区人民医院感染性疾病病原菌的分布及耐药性。结果共分离出病原菌13 614株,标本主要来源于痰液、分泌物、尿液、血液,分别占38.10%、19.00%、14.31%、13.41%。革兰阴性杆菌共8 808株,占64.70%,革兰阳性球菌3 796株,占27.88%,革兰阳性杆菌76株,占0.56%;革兰阴性球菌7株,占0.05%,真菌927株,占6.81%。不同部位标本分离的病原菌有所不同。大肠埃希菌、肺炎克雷伯菌对氨苄西林耐药率较高,对美罗培南、亚胺培南、哌拉西林/他唑巴坦、阿米卡星的耐药率低于5%以下;铜绿假单胞菌对头孢唑林、呋喃妥因、复方新诺明、氨苄西林、头孢呋辛钠、头孢曲松的耐药率均在90%以上,对阿米卡星的耐药率在10%以下;鲍曼不动杆菌对阿米卡星耐药率在5%以下,对大部分药物的耐药率较高。金黄色葡萄球菌、表皮葡萄球菌对万古霉素、利奈唑胺、替加环素无耐药,对青霉素、红霉素耐药率较高;肺炎链球菌对克林霉素、红霉素耐药率较高,对万古霉素、利福平无耐药;屎肠球菌对克林霉素、红霉素、青霉素耐药率较高,对替加环素无耐药,对万古霉素、利奈唑胺耐药率为1.98%。结论天津市宝坻区人民医院分离的病原菌对抗菌药物有不同程度的耐药,加强病原学检查及耐药监测有助于临床合理选择抗菌药。
Objective To analyze the distribution and drug resistance of pathogenic bacteria of infectious diseases in Baodi District People's Hospital of Tianjin from 2014 to 2018, and to provide the basis for rational drug use. Methods The distribution and drug resistance of pathogenic bacteria of infectious diseases in the Baodi District People's Hospital of Tianjin from 2014 to 2018 were retrospectively analyzed. Results Total 13 614 strains of pathogens were isolated, the specimens mainly came from sputum, secretion, urine, and blood, accounting for 38.10%, 19.00%, 14.31%, and 13.41%, respectively. There were 8 808 strains of Gram-negative bacilli(64.70%). Gram-positive coccus(3 796 strains) accounted for 27.88%, and Gram-positive bacilli(76 strains) accounted for 0.56%, and Gram-negative coccus(7 strains) accounted for 0.05%, and fungi(927 strains) accounted for 6.81%. Pathogenic bacteria isolated from different parts of specimens were different. The drug resistance rate of Escherichia coli and Klebsiella pneumoniae against ampicillin were higher, and against meropenem, imipenem, piperacillin/tazobactam, and amikacin were below 5%. The drug resistance rate of Pseudomonas aeruginosa against cefazolin, furantoin, compound neotamine, ampicillin, cefuroxime sodium, and ceftriaxone were above 90%, and the drug resistance rate against amikacin was below 10%. The drug resistance rate of Acinetobacter baumannii against amikacin was below 5%, and the drug resistance rate against most drugs was higher. Staphylococcus aureus and Staphylococcus epidermidis were sensitive to vancomycin, linezolid, and tegacycline, and the drug resistance rates against penicillin and erythromycin were higher. The drug resistance rate of Streptococcus pneumoniae against clindamycin and erythromycin were higher, and S. pneumoniae was sensitive to vancomycin and rifampicin. The drug resistance rate of Enterococcus faecium against clindamycin, erythromycin and penicillin were higher. E. faecium was sensitive to tegacycline, and the drug resistance rate against vancomycin and linezolid was 1.98%. Conclusion Pathogens isolated in Baodi District People's Hospital of Tianjin have different degrees of resistance to antimicrobial drugs. Strengthening pathogenic examination and drug resistance monitoring is helpful for rational selection of antibiotics in clinic.
Objective To analyze the distribution and drug resistance of pathogenic bacteria of infectious diseases in Baodi District People's Hospital of Tianjin from 2014 to 2018, and to provide the basis for rational drug use. Methods The distribution and drug resistance of pathogenic bacteria of infectious diseases in the Baodi District People's Hospital of Tianjin from 2014 to 2018 were retrospectively analyzed. Results Total 13 614 strains of pathogens were isolated, the specimens mainly came from sputum, secretion, urine, and blood, accounting for 38.10%, 19.00%, 14.31%, and 13.41%, respectively. There were 8 808 strains of Gram-negative bacilli(64.70%). Gram-positive coccus(3 796 strains) accounted for 27.88%, and Gram-positive bacilli(76 strains) accounted for 0.56%, and Gram-negative coccus(7 strains) accounted for 0.05%, and fungi(927 strains) accounted for 6.81%. Pathogenic bacteria isolated from different parts of specimens were different. The drug resistance rate of Escherichia coli and Klebsiella pneumoniae against ampicillin were higher, and against meropenem, imipenem, piperacillin/tazobactam, and amikacin were below 5%. The drug resistance rate of Pseudomonas aeruginosa against cefazolin, furantoin, compound neotamine, ampicillin, cefuroxime sodium, and ceftriaxone were above 90%, and the drug resistance rate against amikacin was below 10%. The drug resistance rate of Acinetobacter baumannii against amikacin was below 5%, and the drug resistance rate against most drugs was higher. Staphylococcus aureus and Staphylococcus epidermidis were sensitive to vancomycin, linezolid, and tegacycline, and the drug resistance rates against penicillin and erythromycin were higher. The drug resistance rate of Streptococcus pneumoniae against clindamycin and erythromycin were higher, and S. pneumoniae was sensitive to vancomycin and rifampicin. The drug resistance rate of Enterococcus faecium against clindamycin, erythromycin and penicillin were higher. E. faecium was sensitive to tegacycline, and the drug resistance rate against vancomycin and linezolid was 1.98%. Conclusion Pathogens isolated in Baodi District People's Hospital of Tianjin have different degrees of resistance to antimicrobial drugs. Strengthening pathogenic examination and drug resistance monitoring is helpful for rational selection of antibiotics in clinic.
引文
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[4]李娜,韩悦,王凡. 2015—2017年天津医科大学第二医院感染性疾病病原菌分布和耐药性分析[J].现代药物与临床, 2018, 33(10):2735-2738.
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[6]王贻兵,李丽,刘丹,等. 2016年中国医科大学附属盛京医院泌尿外科病原菌的分布及耐药性分析[J].现代药物与临床, 2018, 33(11):3049-3054.
[7]赵珂,夏鹏程,张志军,等. 4 828株大肠埃希菌的临床分布及耐药分析[J].国际检验医学杂志, 2018, 39(14):1765-1768.
[8] Jamil B, Habib H, Abbasi S, et a1. Cefazolin loaded chitosan nan—oparticles to cure multi drug resistant Gram-negative pathogens[J]. Carbohydr Polym, 2016,136:682.
[9]张祎博,孙景勇,倪语星,等. 2005—2014年CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志,2016, 16(2):141-145.
[10]李耘,吕媛,郑波,等.中国细菌耐药监测研究2015—2016革兰阳性菌监测报告[J].中国临床药理学杂志, 2017, 33(23):2543-2556.
[11]黄青,殷俊,陈曦,等.β-溶血性链球菌红霉素耐药特征与大环内酯类耐药基因的分析[J].中国抗生素杂志, 2015, 40(9):690-694.
[12]曾繁旭,乔建军.多烯大环内酯类抗生素的研究进展[J].中国抗生素杂志, 2014, 39(3):171-181.
[2] Clinical and Laboratory Standards Institute(CLSI).Performance Standards for Antimicrobial Susceptibility Testing[S]. 2012:M100-S22.
[3]谢敬亮. 2014—2016年北京小汤山医院医院感染病原菌的分布和耐药分析[J].现代药物与临床, 2017,32(4):742-746.
[4]李娜,韩悦,王凡. 2015—2017年天津医科大学第二医院感染性疾病病原菌分布和耐药性分析[J].现代药物与临床, 2018, 33(10):2735-2738.
[5]杨玉霞,栾斌,马丽娜. 2000—2010年下呼吸道感染病原菌构成变迁及耐药性分析[J].中华医院感染学杂志, 2011, 21(16):3509-3511.
[6]王贻兵,李丽,刘丹,等. 2016年中国医科大学附属盛京医院泌尿外科病原菌的分布及耐药性分析[J].现代药物与临床, 2018, 33(11):3049-3054.
[7]赵珂,夏鹏程,张志军,等. 4 828株大肠埃希菌的临床分布及耐药分析[J].国际检验医学杂志, 2018, 39(14):1765-1768.
[8] Jamil B, Habib H, Abbasi S, et a1. Cefazolin loaded chitosan nan—oparticles to cure multi drug resistant Gram-negative pathogens[J]. Carbohydr Polym, 2016,136:682.
[9]张祎博,孙景勇,倪语星,等. 2005—2014年CHINET铜绿假单胞菌耐药性监测[J].中国感染与化疗杂志,2016, 16(2):141-145.
[10]李耘,吕媛,郑波,等.中国细菌耐药监测研究2015—2016革兰阳性菌监测报告[J].中国临床药理学杂志, 2017, 33(23):2543-2556.
[11]黄青,殷俊,陈曦,等.β-溶血性链球菌红霉素耐药特征与大环内酯类耐药基因的分析[J].中国抗生素杂志, 2015, 40(9):690-694.
[12]曾繁旭,乔建军.多烯大环内酯类抗生素的研究进展[J].中国抗生素杂志, 2014, 39(3):171-181.