摘要
目的了解宁夏医科大学总医院2019—2024年肺泡灌洗液(BALF)分离病原菌分布及耐药性,为指导临床合理选用抗菌药物提供理论参考。方法收集2019年1月—2024年12月宁夏医科大学总医院临床送检支气管肺泡灌洗液(BALF)中分离菌株药敏试验结果资料,采用WHONET 5.6软件进行数据分析。结果共收集BALF分离菌1904株,其中革兰阴性菌占77.4%,革兰阳性菌占22.6%。排名前6位的病原菌依次为鲍曼不动杆菌(16.1%)、肺炎克雷伯菌(14.8%)、铜绿假单胞菌(14.4%)、流感嗜血杆菌(8.2%)、肺炎链球菌(6.5%)、金黄色葡萄球菌(6.3%)。药敏结果显示,肺炎克雷伯菌对碳青霉烯类耐药率<2.0%,对头孢菌素类耐药率逐年升高。大肠埃希菌对碳青霉烯类耐药率<3.0%,对哌拉西林/他唑巴坦、阿米卡星耐药率均<14.0%。鲍曼不动杆菌对大部分抗菌药物耐药率>50.0%。铜绿假单胞菌对大部分抗菌药物耐药率<14.0%。流感嗜血杆菌β-内酰胺酶阳性率为61.9%。肺炎链球菌对青霉素敏感率为100%,对红霉素和克林霉素耐药率>90.0%。金黄色葡萄球菌对万古霉素、替考拉宁、利奈唑胺的敏感率为100%,MRSA检出率为25.8%。结论我院BALF标本分离株以革兰阴性菌为主,整体耐药率呈上升趋势。纹带棒杆菌引起住院患者下呼吸道感染有上升趋势,需引起临床重视。同时临床需重视下呼吸道感染患者的病原学检测,送检高质量BALF标本。应进一步加强抗菌药物使用的监测与管理,遏制耐药菌的传播。
Objective To understand the distribution and antimicrobial resistance of bacteria isolated from bronchoalveolar lavage fluid(BALF)in General Hospital of Ningxia Medical University from 2019 to 2024,and provide a reference for the rational application of antibacterial drugs and antimicrobial therapy.Methods The clinical isolates in BALF of pathogenic bacteria were collected from Ningxia Medical University General Hospital from January 2019 to December 2024.The antimicrobial susceptibility was tested for these isolates.The susceptibility testing results were analyzed by WHONET 5.6 software.Results A total of 1904 strains of bacteria isolated from BALF were included in this study,of which 77.4%were Gram-negative bacteria and 22.6%were Gram-positive bacteria.The top six species were Acinetobacter baumannii(A.baumannii)(16.1%),Klebsiella pneumoniae(K.pneumoniae)(14.8%),Pseudomonas aeruginosa(P.aeruginosa)(14.4%),Haemophilus influenzae(H.influenzae)(8.2%),Streptococcus pneumoniae(S.pneumoniae)(6.5%),and Staphylococcus aureus(S.aureus)(6.3%).The resistance rate of K.pneumoniae to carbapenems was<2.0%,the resistance rate of K.pneumoniae to cephalosporins increased year by year.Less than 3.0%of E.coli strains were resistant to carbapenems,and less than 14.0%of the strains were resistant to piperacillin-tazobactam and amikacin.The resistance rate of A.baumannii to most antimicrobial agents was>50.0%.The resistance rate of P.aeruginosa to most antimicrobial agents was<14.0%.The prevalence ofβ-lactamase-producing strains was 61.9%in H.influenzae.The resistance rate of S.pneumoniae to penicillin was 0%,and the resistance rate to erythromycin and clindamycin was>90.0%.None of S.aureus strains were resistant to vancomycin,teicoplanin,or linezolid and the prevalence of MRSA was 25.8%.Conclusion The main bacteria isolated from BALF specimens in the General Hospital of Ningxia Medical University were mainly Gram-negative bacteria.The antimicrobial resistance of the bacterial isolates was on the rise.There was an increasing trend of lower respiratory tract infection of inpatients caused by Corynebacterium striatum,which needed attention in clinical treatment.The clinical attention should paid to the pathogen detection of lower respiratory tract infection,and the high-quality BALF specimens should be sent for clinical examination.It is necessary to further strengthen the rational use and stewardship of antimicrobials to curb the spread of drug-resistant bacteria.
作者
殷国民
马红
陶佳
李刚
Yin Guomin;Ma Hong;Tao Jia;Li Gang(Medical Experimental Center,General Hospital of Ningxia Medical University,Yinchuan 750004;Ningxia Key Laboratory of Clinical and Pathogenic Microbiology,Yinchuan 750004)
出处
《中国抗生素杂志》
北大核心
2025年第11期1363-1370,I0001,共9页
Chinese Journal of Antibiotics
基金
宁夏回族自治区重点研发计划(No.2023BEG03046)
宁夏医科大学校级科研项目(No.XY2024051)。
关键词
下呼吸道感染
支气管肺泡灌洗液
病原菌
抗菌药物
耐药性
Lower respiratory tract infection
Bronchoalveolar lavage fluid
Pathogen
Antimicrobial agents
Antimicrobial resistance
