摘要
目的探讨广州地区某三甲医院普通外科多重耐药现状,分析发生多重耐药的原因,为制定应对策略提供参考。方法统计广州市花都区人民医院普通外科2017年目标监测多重耐药菌的例数及其构成比,分析多重耐药患者的疾病构成及年龄分布,寻找出现多重耐药的原因。结果 2017年普通外科共发生434例多重耐药,目标监测多重耐药菌主要是大肠埃希菌,占73.50%,且对头孢类抗菌药物和喹诺酮类抗菌药物的耐药比例较高。病种分布中阑尾炎患者约占61.52%(267/434),且以急性阑尾炎患者为主(125例,46.82%)。年龄集中分布于青、中年患者,65岁以下的患者占88.02%(382/434)。403例(92.86%)为非外伤性疾病,91例(20.97%)存在合并症,307例(70.74%)未更改经验性抗感染治疗方案。结论普通外科多重耐药渐趋明显,其中大肠埃希菌多重耐药率高于全院甚至全国的耐药率,且多重耐药患者的病种和年龄分布异常,其原因可能与医疗机构以及患者不合理使用抗菌药物导致细菌变异有关,同时不排除为本地区畜牧养殖业滥用抗菌药物的原因。
Objective：To investigate the multiple drug resistance status of general surgery in a tertiary hospital in Guangzhou, analyze the causes of multiple drug resistance, and to provide references for the formulation of multiple drug resistance strategies. Methods：Through analyzing the number and proportion of multi-drug resistant bacteria which were target monitored by the Department of General Surgery of Huadu District People＇s Hospital of Guangzhou in 2017, the disease structure and age distribution of multi-drug resistant patients were analyzed, and the causes of multiple drug resistance were investigated. Results：A total of four hundred and thity-four multi-drug resistant patients occurred in the Department of General Surgery in 2017. The target multi-drug resistant strain was Escherichia coli, accounting for 73.50%, and the resistance rate to cephalosporin antibiotics and quinolones was higher. The appendicitis patients accounted for 61.52% （267/434） of the disease distribution, and mainly for patients with acute appendicitis （125 cases, 46.82%）. The age is mainly distributed in young and middle-aged patients, and about 88.02% of patients were under 65 years old （382/434）; 403 cases （92.86%） had non-traumatic diseases, 91 cases （20.97%） had comorbidities, and 307 cases （70.74%） did not change the empirical anti-infective treatment plan. Conclusions：The multi-drug resistance of department of general surgery is gradually becoming obvious, the multi-drug resistance rate of Escherichia coli significantly higher than that of the whole hospital and even the whole country, and there are diseases and age distribution abnormalities in patients with multiple drug resistance. The reasons may be related to the bacterial mutation caused by unreasonable use of antibiotics in medical institutions and patients, and do not exclude the reasons for the abuse of antibiotics in animal husbandry industry in local area.
作者
郭胜蓝
陈浩
罗崇彬
曹天生
王快
罗柠
Guo Shenglan;Chen Hao;Luo Chongbin;Cao Tiansheng;Wang Kuai;Luo Ning(Department of Pharmacy;Department of General Surgery,Huadu District People＇s Hospital of Guangzhou,Guangzhou 510800,China)
出处
《中华普通外科学文献（电子版）》
2018年第6期439-443,共5页
Chinese Archives of General Surgery(Electronic Edition)
关键词
普通外科
抗药性
多药
阑尾炎
大肠埃希菌
General surgery
Drug resistance
multiple
Appendicitis
Escherichia coli
