2016—2018年阳江市人民医院感染病原菌的分布及耐药性分析

目的 探究2016—2018年阳江市人民医院感染病原菌的分布及耐药性，旨在为临床的治疗提供科学依据。方法 分析2016年1月—2018年8月阳江市人民医院524例感染患者，进行病原菌检测、鉴定以及药敏试验，统计并病原菌的分布以及耐药性。结果 对524例感染患者进行病原菌检测并检出病原菌603株，标本主要来源于痰和血液，构成比为39.50%、21.56%，科室主要分布于ICU和骨科，构成比分别为44.47%、21.76%。其中革兰阴性菌361株（59.97%），主要为大肠埃希菌、鲍曼不动杆菌、肺炎克雷伯菌；革兰阳性菌203株（33.67%），主要为金黄色葡萄球菌、肺炎链球菌；真菌31株（5.14%）。大肠埃希菌对妥布霉素、头孢西丁、头孢他啶、头孢噻肟的耐药率高于50%，对头孢吡肟、头孢哌酮、美罗培南、氨曲南的耐药率低于10%，鲍曼不动杆菌对左氧氟沙星、氨苄西林、庆大霉素、氨曲南的耐药率高于50%，对阿米卡星、头孢吡肟、头孢哌酮的耐药率低于10%，肺炎克雷伯菌对妥布霉素、氨苄西林、头孢他啶、头孢西丁、头孢噻肟、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%；金黄色葡萄球菌对左氧氟沙星、苯唑西林、青霉素G、四环素、复方新诺明的耐药率高于50%，对利奈唑胺、环丙沙星、万古霉素、红霉素、替加环素的耐药率低于10%，肺炎链球菌对青霉素G、环丙沙星、庆大霉素、四环素的耐药率高于50%，对万古霉素、复方新诺明、红霉素、替加环素的耐药率低于10%。结论 2016—2018年阳江市人民医院感染患者病原菌以革兰阴性菌为主，耐药性现象较高，临床上应该通过检测感染患者的病原菌种类合理的选择抗生素进行治疗。

Analysis on distribution and drug resistance of pathogenic bacteria of infectious diseases in Yangjiang Hospital from 2016 to 2018

Objective To explore the distribution and drug resistance of pathogenic bacteria of infectious diseases in Yangjiang Hospital from 2016 to 2018, in order to provide a scientific basis for clinical treatment. Methods Infected patients (524 cases) from Yangjiang Hospital from January 2016 to August 2018 were analyzed. Pathogen detection, identification, and drug susceptibility testing were performed, and the distribution of pathogens and drug resistance were counted. Results Infected patients (524 cases) were tested for pathogens and 603 strains of pathogens were detected. The sputum and blood samples were the main source, accounting for 39.50% and 21.56%. Most pathogenic bacteria were mainly detected from Intesive Care Unit and Department of Orthopedics, accounting for 44.47% and 21.76%. Gram-negative (361 strains) accounted for 59.97%, and main of them were Escherichia coli, Acinetobacter baumannii, and Klebsiella pneumonia. Gram-positive bacteria bacteria were 203 strains (33.67%), and main of them were Staphylococcus aureus and Streptococcus pneumonia. There was 31 strains of fungi (5.14%). The drug resistance rate of E. coli against tobramycin, cefoxitin, ceftazidime, and cefotaxime was more than 50%, and the drug resistance rate against cefepime, cefoperazone, meropenem, and aztreonam was less than 10%. The drug resistance rate of A. baumannii against levofloxacin, ampicillin, gentamicin, and aztreonam was more than 50%, and the drug resistance rate against amikacin, cefepime, and cefoperazone was less than 10%. The drug resistance rate of K. pneumoniae against tobramycin, ampicillin, ceftazidime, cefoxitin, cefotaxime, and aztreonam was higher than 50%, and the drug resistance rate against amikacin, meropenem, and cefoperazone was less than 10%. The drug resistance rate of S. aureus against levofloxacin, oxacillin, penicillin G, tetracycline, and cotrimoxazole was more than 50%, and the drug resistance rate against linezolid, ciprofloxacin, vancomycin, erythromycin, and tigecycline was less than 10%. The drug resistance rate of S. pneumoniae against penicillin G, ciprofloxacin, gentamicin, and tetracycline was more than 50%, and the drug resistance rate resistance against vancomycin, co-trimoxazole, erythromycin, and tigecycline was lower than 10%. Conclusion The pathogens of infectious diseases were mainly Gram-negative bacteria in Yangjiang Hospital from 2016 to 2018, and the drug resistance phenomenon was high. It should be treated clinically by selecting antibiotics for the pathogens of patients with infectious diseases.