2015-2017年天津医科大学第二医院感染性疾病病原菌分布及耐药性分析

目的 分析2015-2017年天津医科大学第二医院感染性疾病病原菌分布及耐药性。方法 收集天津医科大学第二医院2015-2017年标本共49 682份，对其感染病原菌的分布及耐药性进行分析。结果 共检出病原菌46 946株，标本来源前3位分别为痰液、血液和尿液，分别占36.42%、23.96%、16.37%。革兰阴性菌31 862株，占67.87%，主要为大肠埃希菌、鲍曼不动杆菌和肺炎克雷伯菌；革兰阳性菌10 756株，占22.91%，主要为金黄色葡萄球菌、肺炎链球菌和表皮葡萄球菌；真菌4 328株，占9.22%，主要为白色假丝酵母菌和热带假丝酵母菌。大肠埃希菌对头孢吡肟、头孢哌酮、亚胺培南、美罗培南、氨曲南的耐药率均在10%以下；鲍曼不动杆菌对左氧氟沙星和氨苄西林的耐药率高达80%以上，而对阿米卡星、头孢吡肟和头孢哌酮的耐药率均在10%以下；肺炎克雷伯菌对氨苄西林、氨曲南的耐药率高达80%以上，而对阿米卡星、头孢哌酮和美罗培南的耐药率均在10%以下。金黄色葡萄球菌对左氧氟沙星、苯唑西林和青霉素G的耐药率高达80%以上，而对利奈唑胺、万古霉素、红霉素和替加环素的耐药率在10%以下；肺炎链球菌对青霉素G的耐药率高达95.72%，而对万古霉素、红霉素、呋喃妥因、复方新诺明、替加环素的耐药率均在10%以下。结论 2015-2017年天津医科大学第二医院临床分离菌株的耐药性较严重，合理选择抗生素治疗具有重要意义。

Analysis on distribution and drug resistance of pathogenic bacteria of infectious diseases in the Second Hospital of Tianjin Medical University from 2015 to 2017

Objective To analyze the distribution and drug resistance of pathogenic bacteria of infectious diseases in the Second Hospital of Tianjin Medical University from 2015 to 2017. Methods A total of 49 682 specimens were collected in the Second Hospital of Tianjin Medical University from 2015 to 2017, and the distribution and drug resistance of pathogenic bacteria were analyzed. Results There were 46 946 strains of pathogens identified. The top three sources of specimens were sputum, blood, and urine, accounting for 36.42%, 23.96%, and 16.37%, respectively. There were 31 862 strains of Gram-negative bacteria (67.87%), mainly Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumoniae. There were 10 756 strains of Gram-positive bacteria (22.91%), mainly Staphylococcus aureus, Streptococcus pneumoniae, and Staphylococcus epidermidis. There were 4 328 strains of Fungi (9.22%), mainly Candida albicans and Candida tropicalis. The drug resistance rate of E. coli against cefepime, cefoperazone, imipenem, meropenem, and aztreonam were below 10%. The drug resistance rate of A. baumannii against levofloxacin and ampicillin were above 80%, while the drug resistance rate against amikacin, cefepime, and cefoperazone were below 10%. K. pneumoniae was resistant to ampicillin and aztreonam, and the drug resistance rate was above 80%. While the drug resistance rate against amikacin, cefoperazone, and meropenem were below 10%. S. aureus was resistant to levofloxacin, oxacillin, and penicillin G with the drug resistance rate above 80%. While the drug resistance rate against linezolid, vancomycin, erythromycin, and tigecycline were below 10%. The drug resistance rate of S. pneumoniae against penicillin G was high to 95.72%, while the drug resistance rate against vancomycin, erythromycin, macrodantin, trimethoprim/sulfamethoxazole, and tigecycline were below 10%. Conclusion The antibiotic resistance of pathogenic bacteria in the Second Hospital of Tianjin Medical University from 2015 to 2017 is more serious. It is of great significance to choose a rational antibiotic treatment.