关键词:

病原菌, 耐药率, 革兰阴性菌, 感染性疾病科

Abstract:

Objective　To understand the distribution of pathogenic bacteria and drug resistance in the department of infectious diseases and other departments in a 3A hospital in recent 5 years, so as to provide a basis for rational clinical application of antimicrobial drugs. Methods　All pathogenic bacteria sent for clinical examination in Binzhou Medical University Hospital from January 2017 to December 2021 were collected, and the distribution of strains, specimen sources, and drug resistance rate from the department of infectious diseases and other departments were analyzed. χ² test was used for statistical analysis. Results　A total of 25 433 non-repeated pathogenic strains were isolated, including 826 strains from the department of infectious diseases and 24 607 strains from other departments. The top three pathogenic bacteria in the department of infectious diseases were Escherichia coli [27.72% (229/826)], Klebsiella pneumoniae [11.50% (95/826)], and Brucella [7.51% (62/826)], and the main sources of specimens were blood [42.86% (354/826)], sputum [24.70% (204/826)], and urine [17.80% (147/826)]. The top three pathogenic bacteria in other departments were Escherichia coli [15.43% (3 797/24 607)], Klebsiella pneumoniae [12.08% (2 973/24 607)], and Staphylococcus aureus [11.19% (2 753/24 607)], and the main sources of specimens were sputum [28.41% (6 991/24 607)], urine [10.29% (2 531/24 607)], and blood [9.82% (2 417/24 607)]. The resistance rates of Escherichia coli isolated from the department of infectious diseases and other departments to ampicillin were the highest [85.15% (195/229) and 83.09% (3 155/3 797)], the resistance rates to levofloxacin were greater than 50%, and the resistance rates to amikacin, furantoin, carbapenems, piperacillin/tazobactam, and cefoperazone/sulbactam were all less than 10%. The resistance rates of Klebsiella pneumoniae isolated from the department of infectious diseases and other departments to cefazolin were the highest [23.16% (22/95) and 32.59% (969/2 973)], the resistance rates to carbapenems were less than 5%, and the resistance rates to third-generation cephalosporins were about 25%. Conclusions　Clinical isolation of pathogenic bacteria is mainly Gram-negative bacteria. Blood specimens and sputum specimens are the main sources of pathogenic bacteria detection, and standardization of specimen extraction and delivery is of great significance to the detection of pathogenic bacteria. The monitoring of pathogenic bacteria and the rational use of antimicrobial drugs should be given high priority by all clinical departments.

Key words:

Pathogenic bacteria, Drug resistance rate, Gram-negative bacteria, Department of infectious diseases