2017—2020年克拉玛依市中心医院抗菌药物使用强度与分离菌耐药性变化情况

目的 分析克拉玛依市中心医院2017—2020年住院患者常见分离菌分布及耐药率的变迁情况，为指导抗菌药物临床合理应用提供依据。方法 收集2017—2020年克拉玛依市中心医院住院患者抗菌药物使用情况及分离菌，分析主要分离菌对常见抗菌药物的耐药率变化趋势。结果 2017—2019克拉玛依市中心医院抗菌药物使用率和使用强度呈下降趋势，4年共有分离菌12 135株，其中革兰阳性菌2 567株，占21.15%；革兰阴性菌6 310株，占52.00%；真菌3 258株，占26.85%。居前5位的分离菌分别是白色假丝酵母菌（19.59%）、大肠埃希菌（16.84%）、肺炎克雷伯菌（13.33%）、鲍曼不动杆菌（8.71%）和铜绿假单胞菌（7.94%）。主要分离菌对常用抗菌药物耐药率总体呈下降趋势，肠杆菌科细菌对临床常用抗菌药物耐药性下降最明显。结论 克拉玛依市中心医院分离菌逐年增加，耐药率有下降趋势，抗菌药物临床应用基本合理，但需完善真菌检测能力。

Changes in intensity of antibiotics use and drug resistance of isolated bacteria in Karamay Central Hospital from 2017 to 2020

Objective To analysis the distribution of common isolates in hospitalized patients and the changes in drug resistance rates in Karamay Central Hospita from 2017 to 2020, to provide a basis for guiding the rational clinical application of antibacterial drugs. Methods The use of antibiotics and isolates of inpatients in the hospital from 2017 to 2020 were collected, and the trend of resistance to common antibiotics of the main isolates was analyzed. Results The use rate and intensity of antibacterial drugs have shown a downward trend. A total of 12 135 strains were isolated in 4 years, of which 2 567 were gram-positive bacteria, accounting for 21.15%, 6 310 were gram-negative bacteria, accounting for 52.0%, and 3 258 were fungi, accounting for 26.85%. The top 5 isolates are Candida albicans (19.59%), Escherichia coli (16.84%), Klebsiella pneumoniae (13.33%), Acinetobacter baumannii (8.71%) and Pseudomonas aeruginosa (7.94%). The resistance rate of main isolates to commonly used antibacterial drugs showed an overall downward trend, and the resistance of Enterobacteriaceae bacteria to clinically used antibacterial drugs decreased most significantly. Conclusion The number of isolates in this hospital has been increasing year by year, and the drug resistance rate has declined. The clinical application of antibacterial drugs is basically reasonable, but the fungal detection capabilities need to be improved.