2016—2018年天津市第一中心医院感染性疾病病原菌的分布及耐药性分析

目的 探究2016—2018年天津市第一中心医院感染性疾病病原菌的分布及耐药性分析。方法 分析2016年1月—2018年10月天津市第一中心医院524例感染性疾病患者，进行病原菌检测、鉴定以及药敏试验，统计并记录病原菌的分布以及各病原菌的耐药性。结果 524例感染性疾病患者检出病原菌503株，革兰阴性菌311株（61.83%），革兰阳性菌153株（30.42%），真菌31株（6.16%），其他8株（1.59%）；革兰阴性菌主要为鲍曼不动杆菌、大肠埃希菌、肺炎克雷伯菌，分别有102株（20.28%）、65株（12.92%）、47株（9.34%），革兰阳性菌以金黄色葡萄球菌、肺炎链球菌为主，分别有54株（10.74%）、32株（6.36%），真菌以热带假丝酵母菌和白色假丝酵母菌为主，分别有13株（2.58%）、11株（2.19%）；大肠埃希菌对头孢西丁、头孢他啶、妥布霉素、头孢噻肟的耐药率较高，对头孢哌酮、头孢吡肟、美罗培南、氨曲南的耐药率低于10%，鲍曼不动杆菌对氨苄西林、左氧氟沙星、氨曲南、庆大霉素的耐药率高于50%，对头孢吡肟、阿米卡星、头孢哌酮的耐药率低于10%；肺炎克雷伯菌对头孢他啶、氨苄西林、妥布霉素、头孢噻肟、头孢西丁、氨曲南的耐药率高于50%，对阿米卡星、美罗培南、头孢哌酮的耐药率低于10%；金黄色葡萄球菌对苯唑西林、左氧氟沙星、四环素、青霉素G、复方新诺明的耐药率高于50%，对环丙沙星、利奈唑胺、红霉素、万古霉素、替加环素的耐药率低于10%，肺炎链球菌对环丙沙星、庆大霉素、青霉素G、四环素的耐药率高于50%，对红霉素、复方新诺明、万古霉素、替加环素的耐药率低于10%。结论 2016—2018年天津市第一中心医院感染性疾病患者病原菌主要为革兰阴性菌，且主要病原菌耐药性较高，临床医师应该对感染性疾病患者进行病原菌检测并选择种类合理的抗生素进行治疗。

Analysis of distribution and drug resistance of pathogenic bacteria of infectious diseases in Tianjin First Central Hospital from 2016 to 2018

Objective To explore the distribution and drug resistance of infectious diseases in Tianjin First Central Hospital from 2016 to 2018, aiming to provide a scientific basis for the clinical treatment of infectious diseases. Methods 524 Cases of infectious diseases from January 2016 to August 2018 in Tianjin First Central Hospital were analyzed. The pathogens were tested, identified and tested for drug susceptibility. The distribution of pathogens and the resistance of various pathogens were recorded and recorded. Results The pathogens were detected in 524 patients with infectious diseases and 503 strains of pathogens were detected, including 311 Gram-negative bacteria (61.83%), 153 Gram-positive bacteria (30.42%), 31 fungi (6.16%), and strain (1.59%). Among them, Gram-negative bacteria were mainly Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumoniae, with 102 strains (20.28%), 65 strains (12.92%), and 47 strains (9.34%). Gram-positive bacteria were mainly Staphylococcus aureus and Streptococcus pneumoniae, with 54 strains (10.74%) and 32 strains (6.36%). The fungi were mainly Candida tropicalis and Candida albicans, with 13 strains (2.58%) and 11 strains (2.19%). Drug sensitivity test results showed that the drug resistance rate of E. coli against tobramycin, cefoxitin, ceftazidime, and cefotaxime were more than 50%, while the drug resistance rate against cefepime, cefoperazone, meropenem, and aztreonam were less than 10%. The drug resistance rate of A. baumannii against levofloxacin, ampicillin, gentamicin, and aztreonam were more than 50%, while the drug resistance rate against amikacin, cefepime, and cefoperazone were less than 10%. The drug resistance rate of K. pneumoniae against tobramycin, ampicillin, ceftazidime, cefoxitin, cefotaxime, and aztreonam was higher than 50%, while the drug resistance rate against amikacin, meropenem, cefoperazone were less than 10%. The drug resistance rate of S. aureus against levofloxacin, oxacillin, penicillin G, tetracycline, and cotrimoxazole were more than 50%, while the drug resistance rate against linezolid, ciprofloxacin, vancomycin, erythromycin, and tigecycline were less than 10%. The drug resistance rate of S. pneumoniae against penicillin G, ciprofloxacin, gentamicin, and tetracycline were more than 50%, while the drug resistance rate against vancomycin, co-trimoxazole, erythromycin, and tigecycline were lower than 10%. Conclusion From 2016 to 2018, the pathogens of patients with infectious diseases in Tianjin First Central Hospital are mainly Gram-negative bacteria, and the main pathogens have high drug resistance. Clinicians should conduct pathogen detection and select a reasonable class of antibiotics for patients with infectious diseases.K