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2019年至2024年某三级医院重症监护病房革兰阴性菌的耐药性分布模式及演变

Distribution patterns and evolution of antimicrobial resistance in Gram-negative bacteria within the intensive care unit of a tertiary hospital from 2019 to 2024.

作者信息

Chen Xiaoying, Liu Xin, Ren Wenyan, Li Hongyan, Yang Siyun

机构信息

Department of Pharmacy, Nanchong Key Laboratory of Individualized Drug Therapy, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China.

Department of Laboratory, Beijing Anzhen Nanchong Hospital of Capital Medical University & Nanchong Central Hospital, Nanchong, China.

出版信息

Front Microbiol. 2025 May 15;16:1587132. doi: 10.3389/fmicb.2025.1587132. eCollection 2025.

Abstract

BACKGROUND

This study aims to investigate the distribution and drug resistance of Gram-negative bacteria in the intensive care unit (ICU) of a tertiary general hospital in Sichuan Province, with the goal of promoting rational antibiotic use and reducing multidrug resistance.

METHODS

A retrospective analysis was conducted on the distribution and drug resistance of Gram-negative bacteria in ICU samples collected from January 2019 to December 2024.

RESULTS

A total of 83,944 culture samples were analyzed, primarily blood (45.27%) and sputum (41.34%) specimens, with a steady increase in sample types annually. A total of 7,211 strains were isolated, 76.43% of which were from respiratory tract specimens. The predominant pathogens included (31.17%), (30.11%), (14.05%), and (11.34%). The detection rates for (CRAB) were 61.88%, (CRKP) 29.28%, (CRPA) 5.80%, and (CREC) 3.04%. Susceptibility testing revealed fluctuating resistance rates for over the past 6 years. Notably, exhibited significant resistance to carbapenems (e.g., imipenem) and third-generation cephalosporins (e.g., ceftazidime).

CONCLUSION

From 2019 to 2024, the ICU experienced a severe problem with Gram-negative drug-resistant bacteria, particularly resistant to third-generation cephalosporins. isolates demonstrated resistance to most antibiotics, underscoring the need for continuous monitoring and the selection of effective antibiotics based on clinical practice.

摘要

背景

本研究旨在调查四川省一家三级综合医院重症监护病房(ICU)革兰阴性菌的分布及耐药情况,以促进抗生素的合理使用并降低多重耐药性。

方法

对2019年1月至2024年12月在ICU采集的样本中革兰阴性菌的分布及耐药情况进行回顾性分析。

结果

共分析了83944份培养样本,主要是血液样本(45.27%)和痰液样本(41.34%),样本类型每年稳步增加。共分离出7211株菌株,其中76.43%来自呼吸道样本。主要病原体包括[具体细菌名称1](31.17%)、[具体细菌名称2](30.11%)、[具体细菌名称3](14.05%)和[具体细菌名称4](11.34%)。耐碳青霉烯类鲍曼不动杆菌(CRAB)的检出率为61.88%,耐碳青霉烯类肺炎克雷伯菌(CRKP)为29.28%,耐碳青霉烯类铜绿假单胞菌(CRPA)为5.80%,耐碳青霉烯类大肠埃希菌(CREC)为3.04%。药敏试验显示过去6年[具体细菌名称]的耐药率波动。值得注意的是,[具体细菌名称]对碳青霉烯类抗生素(如亚胺培南)和第三代头孢菌素(如头孢他啶)表现出显著耐药性。

结论

2019年至2024年,ICU面临革兰阴性耐药菌的严重问题,尤其是对第三代头孢菌素耐药的[具体细菌名称]。[具体细菌名称]分离株对大多数抗生素耐药,强调需要持续监测并根据临床实践选择有效的抗生素。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3e5c/12119562/fed6f064ff43/fmicb-16-1587132-g001.jpg

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