| 上海某二级医院革兰阴性菌流行特征的回顾性分析 |
| 投稿时间：2023-05-06 修订日期：2024-04-30 点此下载全文 |
| 引用本文：戴菲菲,傅翔,陈琼年,俞苏纯.上海某二级医院革兰阴性菌流行特征的回顾性分析[J].药学实践杂志,2024,42(12):528~532 |
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| 中文摘要:目的 回顾性分析医院内分离病原细菌（特别是革兰阴性菌，G-菌）的分布情况和耐药特征，以促进医院合理使用抗菌药。方法 收集2018年7月至2023年3月每季度全院分离检出的病原菌以及药物敏感试验结果，并进行回顾性分析。结果 共分离检出病原细菌14 844株，其中，革兰阳性菌（G+菌）4 757株（32.05%），G-菌10 087株（67.95%）。产超广谱β-内酰胺酶大肠埃希菌检出率为43.23%，对碳青霉烯类和加酶抑制剂保持着较高的敏感性，敏感率约99.00%。肺炎克雷伯菌的耐药情况较为严重，出现耐碳青霉烯、多重耐药和泛耐药菌。2022年，碳青霉烯类耐药肺炎克雷伯菌检出率为54.82%；非发酵菌中碳青霉烯类耐药铜绿假单胞菌和碳青霉烯类耐药鲍曼不动杆菌的检出率为22.02%和74.34%，多重耐药的鲍曼不动杆菌的检出率>70%。结论 G-菌耐药问题仍较为严重，特别是肺炎克雷伯和鲍曼不动杆菌。细菌耐药问题给临床治疗带来极大的挑战，有必要进行定期监测以促进合理用药。 |
| 中文关键词:细菌耐药 抗生素 革兰阴性菌 |
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| Retrospective analysis of the epidemic characteristics of Gram-negative bacteria in a second-class hospital in Shanghai |
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| Abstract:Objective To retrospectively analyze the distribution and drug resistant characteristics of isolated pathogens （especially Gram-negative bacteria） in hospital and promote the rational use of antibacterial drugs. Methods The pathogens and drug sensitivity test results were collected from the whole hospital every quarter from July 2018 to March 2023, and were conducted retrospective analysis. Results A total of 14 844 pathogens were isolated and detected, including 4 757 Gram-positive bacteria （32.05%） and 10 087 Gram-negative bacteria （67.95%）. The detection rate of extended spectrum beta-lactamases Escherichia coli was 43.23%, and it maintained high sensitivity to carbapenems and enzyme inhibitors, and the sensitivity rate was about 99.00%. The drug resistance of Klebsiella pneumoniae was more serious, and carbapenem-resistant, multi-drug resistance and extensively-drug resistance appeared. In 2022，the detection rate of carbapenem-resistant Klebsiella pneumoniae was 54.82%; the detection rates of carbapenem-resistant Pseudomonas Aeruginosa and carbapenem-resistant Acinetobacter baumannii in non-fermentative bacteria were 22.02% and 74.34%, the detection rate of multi-drug resistant Acinetobacter baumannii was >70%. Conclusion The problem of drug resistance of Gram-negative bacteria was still serious, especially in Klebsiella pneumoniae and Acinetobacter baumannii. The problem of bacterial resistance poses great challenges to clinical treatment, and it is necessary to conduct regular monitoring and promote rational drug use. |
| keywords:bacterial resistance antibiotics Gram-negative bacteria |
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