2016-2018年天津市第五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年天津市第五中心医院感染性疾病病原菌的分布及耐药性。方法 回顾性分析2016年1月-2018年12月天津市第五中心医院感染病原菌的分布，并对病原菌进行耐药性检测。结果 3 103株感染病原菌中，革兰阴性菌1 793株（57.78%），以鲍曼不动杆菌（15.73%）、大肠埃希菌（18.66%）为主，鲍曼不动杆菌对头孢西丁（81.37%）、头孢吡肟（71.15%）具有较高的耐药性，对阿莫西林（30.44%）具有较低的耐药性，大肠埃希菌对头孢他啶（51.77%）、头孢吡肟（46.12%）具有较高的耐药性，对哌拉西林（7.17%）、阿米卡星（5.37%）的耐药性低；革兰阳性菌共1 109株（35.74%），以肺炎链球菌（9.96%）、金黄色葡萄球菌（16.98%）为主，肺炎链球菌和金黄色葡萄球菌对红霉素、青霉素的耐药性高，对头孢唑啉和左氧氟沙星具有较低的耐药性；真菌共201株（6.48%），以白假丝酵母菌（2.96%）为主，白假丝酵母菌对伊曲康唑（13.07%）、氟康唑（4.28%）、5-氟胞嘧啶（2.98%）、伏力康唑（2.73%）等抗菌药物的耐药性较低。结论 天津市第五中心医院的感染病原菌主要为条件致病菌，耐药性严重；医院应定期对病原菌进行耐药性分析，并指导医师合理使用抗菌药物。

Distribution and drug resistance of pathogenic bacteria of infectious diseases in the Fifth Central Hospital of Tianjin from 2016 to 2018

Objective To investigate the distribution and drug resistance of pathogenic bacteria of infectious diseases in the Fifth Central Hospital of Tianjin from 2016 to 2018. Methods The distribution of pathogenic bacteria in the Fifth Central Hospital of Tianjin from January 2016 to December 2018 was retrospectively analyzed. The drug resistance of pathogens was detected. Results A total of 3 103 strains of pathogens were selected, in which 1 793 strains (57.78%) were Gram-negative bacteria, mainly Acinetobacter baumannii (15.73%) and Escherichia coli (18.66%). A. baumannii had high drug resistance against cefoxitin (81.37%) and cefepime (71.15%), and had low drug resistance to amoxicillin (30.44%). E. coli had high drug resistance against ceftazidime (51.77%) and cefepime (46.12%), and had low resistance against piperacillin (7.17%) and amikacin (5.37%). Gram-positive bacteria were 1 109 strains (35.74%), and main of them were Streptococcus pneumoniae (9.96%) and Staphylococcus aureus (16.98%). S. pneumoniae and S. aureus were highly resistant to erythromycin and penicillin, while they had lower drug resistance to cefazolin and levofloxacin. Fungi were 201 strains (6.48%), and main of them was Candida albicans (2.96%). C. albicans had lower drug resistance to itraconazole (13.07%), fluconazole (4.28%), 5-fluorocytosine (2.98%), and fluconazole (2.73%). Conclusion The infection pathogens in the Fifth Central Hospital of Tianjin are mainly pathogenic bacteria, and the drug resistance is serious. The hospital should regularly analyze the drug resistance of pathogens and guide the physicians to use antibiotics rationally.