摘要
目的 了解山西医科大学第一医院综合ICU医院感染患者感染病原菌菌种,并进行耐药性分析。方法回顾性分析山西医科大学第一医院2017—2021年综合ICU医院感染患者的临床资料,总结患者感染发病率、病原菌菌种及感染部位,分析革兰阴性菌和革兰阳性菌的耐药情况。结果 共有3 608例患者,感染532例,感染发病率为14.75%,感染例次发病率为21.62%,均随年份增加呈下降趋势。共检出1 216株病原菌,主要是革兰阴性菌844株(69.41%),其次是革兰阳性菌232株(19.08%)和真菌140株(11.51%)。综合ICU医院感染部位以呼吸系统为主,占55.51%。耐碳青霉烯类肺炎克雷伯菌总体检出率为43.44%,5年间呈下降趋势;产超广谱β-内酰胺酶肺炎克雷伯菌总体检出率为25.36%,5年间呈上升趋势;鲍曼不动杆菌对碳青霉烯类、头孢菌素类和青霉素类抗生素耐药率>80%,耐碳青霉烯类鲍曼不动杆菌检出率>75%;耐碳青霉烯类铜绿假单胞菌检出率为41.51%~42.62%。屎肠球菌对青霉素类和喹诺酮类抗生素耐药率>90%,对万古霉素和替考拉宁敏感;凝固酶阴性葡萄球菌和表皮葡萄球菌对青霉素类抗生素耐药率>80%,对利奈唑胺、万古霉素和替考拉宁敏感;耐甲氧西林金黄色葡萄球菌检出率为27.27%~35.71%。结论 革兰阴性菌是本院综合ICU医院感染的主要病原菌,感染部位主要是呼吸系统。肺炎克雷伯菌和鲍曼不动杆菌耐药率高,部分菌株多重耐药率比较高。
Objective To understand the pathogenic bacteria strains in patients with nosocomial infection in the comprehensive ICU of the First Hospital of Shanxi Medical University and to analyse their drug resistance.Methods We retrospectively analyzed the clinical data of patients with nosocomial infection in the comprehensive ICU of the First Hospital of Shanxi Medical University from 2017 to 2021,summarized the incidence of infection,pathogenic bacteria species and sites of infection in patients,and analyzed the drug resistance of Gram-negative and Gram-positive bacteria.Results There were 3 608 patients with 532 cases of infections,an incidence of infection of 14.75% and an incidence of infection cases of 21.62%,both of which showed a decreasing trend with increasing years.A total of 1 216 pathogenic strains were detected,mainly Gram-negative bacteria of 844(69.41%),followed by Gram-positive bacteria of 232(19.08%) and fungi of 140(11.51%).The site of infection in the comprehensive ICU hospitals was predominantly respiratory system,accounting for 55.51%.The overall detection rate of carbapenem-resistant Klebsiella pneumoniae was 43.44%,with a downward trend over the five-year period.The overall detection rate of Klebsiella pneumoniae with ultra broad spectrum β-lactamase was 25.36%,with an increasing trend over the five-year period.The resistance rate of Acinetobacter baumannii to carbapenems,cephalosporins and penicillins was more than 80%,and the detective rate of carbapenem-resistant A.baumannii was more than 75%;the detection rate of carbapenem-resistant Pseudomonas aeruginosa ranged from 41.51% to42.62%.The resistance rate of Enterococcus faecalis to penicillins and quinolones was more than 90%,and they were sensitive to vancomycin and teicoplanin.The resistance rate of Coagulase-negative staphylococci and Staphylococcus epidermidis to penicillin antibiotics was more than 80%,and they were sensitive to linezolid,vancomycin and teicoplanin.The detection rate of methicillin-resistant Staphylococcus aureus ranged from 27.27% to 35.71%.Conclusions Gram-negative bacteria are the main pathogens of hospital-acquired infections in our comprehensive ICU,with the main site of the respiratory system.Klebsiella pneumoniae and Acinetobacter baumannii have high rates of drug resistance and some multidrug resistant bacteria are detected at a relatively high rate.
作者
王平
李红
苏丹霞
WANG Ping;LI Hong;SU Danxia(School of Public Health,Shanxi Medical University,Taiyuan 030000,China)
出处
《山东医药》
CAS
2022年第27期30-35,共6页
Shandong Medical Journal
关键词
院内感染
感染病原菌
病原菌菌种
病原菌耐药
nosocomial infection
infectious agents
pathogenic strains
pathogenic bacterial resistance
作者简介
第一作者:王平(1993-),女,硕士,主要研究方向为医院感染控制。E-mail:1593733078@qq.com;通信作者:李红(1972-),女,博士,主任医师,主要研究方向为医院感染控制、肝病基础与临床。E-mail:lihong6403@126.com。
