摘要
目的明确热带地区呼吸道感染检出病原菌及耐药情况,为指导合理选择抗菌药物治疗医院呼吸道感染提供参考。方法收集2016-2020年某医院发生呼吸道感染住院患者检出的病原菌,并对主要病原菌耐药性进行回顾性分析。结果2857例次医院呼吸道感染患者共分离出病原菌2992株,其中革兰阴性菌1839株占61.46%,以鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌、大肠埃希菌为主;革兰阳性菌527株占17.61%,以金黄色葡萄球菌为主(其中耐甲氧西林金黄色葡萄球菌12株);真菌626株占20.92%,以白假丝酵母为主;近5年鲍氏不动杆菌、白假丝酵母和热带假丝酵母检出率显示下降趋势(P<0.05)。肺炎克雷伯菌、鲍氏不动杆菌和铜绿假单胞菌对亚胺培南耐药率分别为12.40%、77.90%和28.46%。结论热带地区检出病原菌主要是革兰阴性菌,以鲍氏不动杆菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌为主;检出菌对广谱青霉素类抗菌药物的耐药性较高,对碳青霉烯类抗菌药物及β-内酰胺酶抑制剂的耐药率相对较低,近5年鲍氏不动杆菌对碳青霉烯类耐药趋势逐年下降,但仍处于较高状态,应加强呼吸道感染耐药菌的防控,合理选择抗菌药物。
OBJECTIVE To clarify the pathogenic bacteria and drug resistance of respiratory tract infection in tropical region,and to provide reference for rational selection of antibiotics for the treatment of nosocomial respiratory tract infection.METHODS The pathogenic bacteria detected in patients with respiratory tract infection in a hospital from 2016 to 2020 were collected,and the drug resistance of the main pathogens was retrospectively analyzed.RESULTS A total of 2992 strains of pathogenic bacteria were isolated from 2857 cases of nosocomial respiratory tract infection,among which 1839 strains of Gram-negative bacteria accounted for 61.46%,mainly Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Escherichia coli.527 strains of Gram-positive bacteria accounted for 17.61%,and Staphylococcus aureus(including 12 strains of methicillin-resistant Staphylococcus aureus)was the main strain.626 strains of fungi accounted for 20.92%,mainly Candida albicans.In recent 5 years,the detection rates of Acinetobacter baumannii,Candida and Candida tropicalis showed a downward trend(P<0.05).The resistance rates of Klebsiella pneumoniae,Acinetobacter baumannii and Pseudomonas aeruginosa to imipenem were 12.40%,77.90%and 28.46%,respectively.CONCLUSION The main pathogens detected in tropical areas were Gram-negative bacteria,including Acinetobacter baumannii,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus.The detected bacteria had high resistance to broad-spectrum penicillin antibiotic,and relatively low resistance rate to carbon penicillium alkene antimicrobial agents and beta lactamase inhibitors.In the past 5 years,the resistance rate of Acinetobacter baumannii to carbapenems had been declining year by year,but it was still at a high level.The prevention and control of drug-resistant bacteria in respiratory tract infection should be strengthened,and antibiotics should be selected reasonably.
作者
孙丹
索继江
施施
杨金燕
孙娜娜
夏婷婷
陈元斌
宋明辉
SUN Dan;SUO Ji-jiang;SHI Shi;YANG Jin-yan;SUN Na-na;XIA Ting-ting;CHEN Yuan-bin;SONG Ming-hui(Hainan Hospital,Chinese PLA General Hospital,Sanya,Hainan 572014,China;不详)
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2022年第20期3062-3066,共5页
Chinese Journal of Nosocomiology
基金
海南省重点研发基金资助项目(ZDYF2021SHFZ262)。
关键词
医院感染
呼吸道感染
病原菌
耐药性
Hospital infection
Respiratory tract infections
Pathogenic bacteria
Drug resistance
