2016—2018年濮阳市人民医院新生儿科重症监护室感染性疾病病原菌分布及耐药性分析

目的了解2016—2018年濮阳市人民医院新生儿科重症监护室感染性疾病病原菌的分布及耐药性,为临床合理使用抗菌药物提供依据。方法回顾性分析2016—2018年濮阳市人民医院新生儿科重症监护室感染性疾病病原菌的分布及耐药性。结果共收集得到1 096份样本,其中样本主要来自血液570例(52.01%),其次为尿液223例(20.35%)、痰液及鼻咽分泌物120例(10.95%);共分离出769株病原菌,其中革兰阴性菌513株,占66.71%,主要为肺炎克雷伯菌、大肠埃希菌和鲍曼不动杆菌;革兰阳性菌221株,占28.74%,主要为金黄色葡萄球菌和肺炎链球菌。大肠埃希菌对头孢噻肟、亚胺培南、多黏菌素E和阿米卡星的药物耐药率均超过60%;鲍曼不动杆菌对头孢他啶、复方新诺明、阿莫西林/棒酸、亚胺培南、多黏菌素E的耐药率均超过60%;肺炎克雷伯菌对复方新诺明、阿莫西林/棒酸、氨苄西林/舒巴坦、美罗培南和呋喃妥因的耐药率均在65%左右。金黄色葡萄球菌和肺炎链球菌均对万古毒素、利奈唑胺的耐药率几乎为0。结论濮阳市人民医院新生儿科重症监护室感染性疾病病原菌分布广泛,建议临床医师根据病原学监测资料有针对性地选择抗生素。

Distribution and drug resistance of pathogenic bacteria of infectious diseases in intensive care unit of neonatology department in Puyang People's Hospital from 2016 to 2018

Objective To understand the distribution and drug resistance of pathogenic bacteria of infectious diseases in intensive care unit of neonatology department in Puyang People''s Hospital from 2016 to 2018, and to provide reference for clinical rational use of antibiotics. Methods A retrospective survey was conducted to analyze the distribution and drug resistance of infectious diseases in intensive care unit of neonatology department in Puyang People''s Hospital from 2016 to 2018. Results A total of 1 096 samples were collected, including 570 samples (52.01%) from blood, 223 samples (20.35%) in urine, and 120 samples (10.95%) in sputum and nasopharyngeal secretions. A total of 769 strains of pathogens were isolated. Gram-negative (513 strains) accounted for 66.71%, and main of them were Klebsiella pneumonia, Escherichia coli, and Acinetobacter baumannii. Gram-positive bacteria bacteria were 221 strains (28.74%), and main of them were Staphylococcus aureus and Streptococcus pneumonia. The drug resistance rate of E. coli against cefotaxime, imipenem, polymyxin E, and amikacin were more than 60%. The drug resistance rate of A. baumannii against ceftazidime, sulfamethoxazole, amoxicillin/clavulanic acid, imipenem, and polymyxin E were more than 60%. The drug resistance rate of K. pneumonia against sulfamethoxazole, amoxicillin/clavulanic acid, ampicillin/sulbactam, meropenem, and macrodantin were about 65%. The drug resistance rate of S. aureus and S. pneumonia against vancomycin and linezolid were next to 0. Conclusion Urinary tract infection pathogens are widely distributed in Wuhan Puren Hospital. The main pathogen is still Gram-negative bacilli. Doctors should select the antibiotics based on the etiology of monitoring data.