2013―2022年某医院肺泡灌洗液病原菌分布及耐药性分析

doi:10.3760/cma.j.issn.1007-1245.2024.05.022

摘要/Abstract

摘要：

目的　分析华中科技大学同济医学院附属同济医院2013―2022年肺泡灌洗液标本中病原菌分布及常见病原菌的耐药性情况。方法　采用回顾性调查研究方法，收集华中科技大学同济医学院附属同济医院2013年1月至2022年12月共送检的36 233例肺泡灌洗液标本，从中分离出非重复病原菌11 801株。使用WHONET5.6版软件对培养及体外药敏试的结果进行分析研究。结果　11 801株病原菌中革兰阴性菌占69.75%（8 231/11 801），革兰阳性菌占11.68%（1 378/11 801），真菌占18.57%（2 192/11 801）。肺炎克雷伯菌（KPN）对阿米卡星、亚胺培南、美罗培南和替加环素敏感性超过70.00%，铜绿假单胞菌（PAE）对除复方新诺明和米诺环素外大多数抗生素敏感性超过40.00%，鲍曼不动杆菌（ABA）对除米诺环素外大多数抗生素耐药性超过75.00%。在最主要致病菌KPN中耐碳青霉烯肺炎克雷伯菌（CRKPN）占比增高的同时耐药性增强；耐甲氧西林金黄色葡萄球菌（MRSA）占比较高，且耐药率高于甲氧西林敏感金黄色葡萄球菌（MSSA）；肺炎链球菌（SPN）中绝大部分为青霉素敏感肺炎链球菌（PSSP）。结论　2013―2022年华中科技大学同济医学院附属同济医院肺泡灌洗液标本分离病原菌主要包括KPN、PAE、ABA和金黄色葡萄球菌（SAU）等，且CRKPN耐药率呈上升趋势，临床需合理用药以降低其耐药性。

关键词:

病原菌, 耐药性, 肺泡灌洗液, 细菌, 药敏试验

Abstract:

Objective　To explore the distribution of pathogens and the resistance of common pathogens in alveolar lavage fluid samples from Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2013 to 2022. Method　Using a retrospective survey research method, 36 233 alveolar lavage fluid samples in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology from 2013 to 2022 were collected, and 11 801 strains of pathogenic bacteria were isolated from the samples. The results of their cultivation and in vitro drug sensitivity tests were analyzed and studied using the WHONET5.6 software. Results　A total of 11 801 strains of non-duplicative isolated pathogens were detected in the alveolar lavage fluid samples; of which, 69.15% (8 321/11 801) were gram-negative bacteria, 2.28% (1 378/11 801) gram-positive bacteria, and 18.57% (2 192/11 801) fungi. Klebsiella pneumoniae (KPN) had a sensitivity of more than 70.00% to amikacin, carbapenems, and tigecycline; Pseudomonas aeruginosa (PAE) had a sensitivity of more than 40.00% to most antibiotics except cotrimoxazole and minocycline; Acinetobacter baumannii (ABA) had a resistance rate more than 75.00% to most antibiotics except minocycline. Among the most important pathogens in KPN, the proportion of Carbapenem-resistant to Klebsiella pneumoniae (CRKPN) increased, and the drug resistance increased. Methicillin-resistant Staphylococcus aureus (MRSA) accounted for a relatively high proportion, and the drug resistance rate was significantly higher than that of Methicillin-susceptible to Staphylococcus aureus (MSSA). The vast majority of Streptococcus pneumoniae (SPN) was Penicillin-susceptible to Streptococcus pneumoniae (PSSP). Conclusion　From 2013 to 2022, the pathogenic bacteria isolated from the alveolar lavage fluid specimens in Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology mainly included KPN, PAE, ABA and Staphylococcus aureus (SAU); the drug resistance rate of CRKPN was on the rise. Therefore, we should rationally use the drugs to decrease its drug resistance.

Key words:

Pathogenic bacteria, Durg resistance, Bronchoalveolar lavage fluid, Bacteria, Drug susceptible test

许超王笑尘田磊.

2013―2022年某医院肺泡灌洗液病原菌分布及耐药性分析 [J]. 国际医药卫生导报, 2024, 30(5): 814-820.

Xu Chao, Wang Xiaochen, Tian Lei.

Distribution and antibiotic resistance analysis of pathogens in alveolar lavage fluid from 2013 to 2022 in some hospital [J]. International Medicine and Health Guidance News, 2024, 30(5): 814-820.

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