肾脏内科住院患者感染病原菌分布及耐药性分析

目的:调查肾脏内科住院患者感染病原菌分布和耐药性，为临床治疗细菌感染的抗菌药物选择提供依据。方法:收集2016年1月至2019年6月期间入住皖南医学院弋矶山医院肾脏内科患者送检标本培养阳性病原菌数据。结果:共培养出286株细菌，以呼吸道感染和泌尿道感染为主。革兰阴性菌占比89.51%，革兰阳性菌占比10.49%。革兰阴性菌中，肠杆菌科细菌检出前三位细菌分别是大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌，非发酵阴性菌检出前二位细菌分别是铜绿假单胞菌、鲍曼不动杆菌；其中产超广谱β内酰胺酶细菌（ESBLs）检出率为32.87%，以大肠埃希菌和肺炎克雷伯菌为主，对氨曲南和头孢曲松耐药率分别为83.8%和100%；碳青霉烯类耐药菌检出率为6.29%。在革兰阳性菌中金黄色葡萄球菌最常见，其中耐甲氧西林金黄色葡萄球菌（MRSA）检出率为4.89%。结论:在本院肾脏内科住院患者细菌感染中，产ESBLs大肠埃希菌和肺炎克雷伯菌检出率高。

Distribution and drug resistance of bacterial pathogens in the infecting inpatients of department of nephrology

AIM:To investigate the etiological distribution and drug resistance of bacterial infection in inpatients of nephrology department and to provide evidence for the selection of antibiotics for clinical treatment of bacterial infection. METHODS:The data of positive pathogenic bacteria were collected from the samples of inpatients of the department of nephrology of Yijishan Hospital of Wannan Medical College from January 2016 to June 2019. RESULTS:A Total of 286 strains of bacteria were cultured, which were mainly from the respiratory tract infection and the urinary tract infection. Gram-negative bacteria accounted for 89.51% and gram positive bacteria accounted for 10.49%. Among Gram-negative bacteria, Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae were the top three bacteria detected in Enterobacteriaceae, while Pseudomonas aeruginosa and Acinetobacter baumannii were the top two bacteria detected in non-fermentative negative bacilli; The detection rate of extended-spectrum β-lactamase-producing bacteria (ESBLs) was 32.87%, which were mainly Escherichia coli and Klebsiella pneumoniae. The resistant rates of Escherichia coli and Klebsiella pneumoniae in ESBLs to aztreonam and ceftriaxone were 83.8% and 100% respectively; The resistance rate of Carbapenem resistance strains was 6.29%. Among Gram-positive bacteria, Staphylococcus aureus was the most common, and the resistance rate of methicillin-resistant Staphylococcus aureus (MRSA) was 4.89%. CONCLUSION:ESBLs-producing Escherichia coli and Klebsiella pneumoniae had high detection rates among isolated bacterial pathogens in the department of nephrology.