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《中华肺部疾病杂志》[ISSN:1006-6977/CN:61-1281/TN]

卷:

期数:

2021年03期

页码:

277-282

栏目:

论著

出版日期:

2021-06-20

文章信息/Info

Title:

Analysis of the distribution and drug susceptibility of 5 155 strains of pathogenic bacteria of hospital-acquired pneumonia

作者:

孙康¹; 李王平¹; 董轲²; 杨铭²; 高彦军¹; 陈敏¹; 李玉娟¹; 潘蕾³; 金发光¹

710032 西安,空军军医大学唐都医院呼吸与危重症医学科¹、检验科² 100000 北京,空军特色医学中心呼吸与危重症医学科³

Author(s):

Sun Kang¹;  Li Wangping¹;  Dong Ke²;  Yang Ming²;  Gao Yanjun¹;  Chen Min¹;  Li Yujuan¹;  Pan Lei³;  Jin Faguang¹.

¹Department of Respiratory and Critical Care Medicine, ²Department of laboratory, Tang Du Hospital, Air Force Military Medical University, Xi'an, Shaanxi, 710032; ³Department of Respiratory and Critical Care Medicine, Air Force Medical Center, Bei Jing 100000, China

关键词:

医院获得性肺炎;  细菌谱;  药物敏感性;  多重耐药菌;  广泛耐药菌

Keywords:

Hospital acquired pneumonia;  Bacteria spectrum;  Drug susceptibility;  Multidrug-resistant bacteria;  Extensively resistant bacteria

分类号:

R563

DOI:

10.3877/cma.j.issn.1674-6902.2021.03.003

摘要:

目的 分析空军军医大学唐都医院医院获得性肺炎(hospital acquired pneumonia, HAP)致病菌分布及药敏试验结果,为经验性治疗HAP提供依据。方法 收集2017年01月至2019年12月我院临床送检呼吸道标本细菌培养结果、药敏试验结果。结果 共筛选合格菌株5 155株,其中鲍曼不动杆菌最多(26.7%),其次为铜绿假单胞菌(19.6%)、肺炎克雷伯菌(14.4%)等。除了多粘菌素和替加环素,鲍曼不动杆菌对头孢哌酮舒巴坦(76.12%)表现出较高的敏感度,其他抗菌素敏感度多低于20%,其中多重耐药、广泛耐药、耐碳青酶烯类鲍曼不动杆菌检出率分别为78.49%、12.28%、84.81%。铜绿假单胞菌对阿米卡星敏感度较高,达86.26%,亚胺培南、美罗培南敏感度较差,约60%,多重耐药、广泛耐药、耐碳青酶烯类铜绿假单胞菌检出率分别为34.42%、3.46%、38.18%。耐碳青酶烯类肠杆菌科细菌检出率为11.67%。未发现对万古霉素、利奈唑胺耐药的金黄色葡萄球菌和肺炎链球菌,耐甲氧西林金黄色葡萄球菌检出率为46.03%。结论 HAP致病菌耐药形势严峻,应引起临床足够重视,加强细菌耐药监测可有效指导临床合理用药。

Abstract:

Objective To analyze the distribution and drug susceptibility of pathogenic bacteria of hospital acquired pneumonia(HAP)in Tang Du Hospital of Air Force Military Medical University, so as to provide reference for the empirical treatment of HAP. Methods Bacterial culture results and drug susceptibility results of clinical respiratory specimens were collected retrospectively from January, 2017 to December, 2019 in our hospital. Results A total of 5155 qualified strains were collected and screened, Acinetobacter baumannii accounted for the most(26.7%), followed by Pseudomonas aeruginosa(19.6%)and klebsiella pneumoniae(14.4%)and so on. In addition to polycolistin and tegacycline, Acinetobacter baumannii showed high sensitivity to cefoperazone-sulbactan(76.12%), while most antibiotics less than 20%. Among them, the detection rates of multi-drug resistant, extensively drug resistant and carbapenem-resistant Acinetobacter baumannii were 78.49%, 12.28% and 84.81%, respectively. The sensitivity of Pseudomonas aeruginosa to amikacin was high up to 86.26%, and that of imipenem and meropenem was lower, about 60%. the detection rates of multi-drug resistant, extensively drug resistant and carbapenem-resistant Pseudomonas aeruginosa were 34.42%, 3.46% and 38.18%, respectively. The detection rate of carbapenem-resistant Enterobacteriaceae was 11.67%, No strains resistant to vancomycin or linezolid were found in Staphylococcus aureus and Streptococcus pneumoniae. The detection of Methicillin-resistant Staphylococcus aureus were 46.03%. Conclusion The situation of drug resistance of HAP pathogens is severe, which should be paid enough attention in clinical practice. Strengthening bacterial drug resistance monitoring can effectively guide clinical rational drug use.

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备注/Memo

备注/Memo:

基金项目: 陕西省科技计划项目(2020SF-112)
通信作者: 潘 蕾, Email: panlei@fmmu.edu.cn

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更新日期/Last Update: 2021-06-20