【作者】 郭胜蓝； 陈浩； 罗崇彬； 曹天生； 王快； 罗柠；

【Author】 Guo Shenglan;Chen Hao;Luo Chongbin;Cao Tiansheng;Wang Kuai;Luo Ning;Department.of Pharmacy,Huadu District People’s Hospital of Guangzhou;Department of General Surgery, Huadu District People’s Hospital of Guangzhou;

【机构】 广州市花都区人民医院药学部； 广州市花都区人民医院普通外科；

【摘要】 目的探讨广州地区某三甲医院普通外科多重耐药现状,分析发生多重耐药的原因,为制定应对策略提供参考。方法统计广州市花都区人民医院普通外科2017年目标监测多重耐药菌的例数及其构成比,分析多重耐药患者的疾病构成及年龄分布,寻找出现多重耐药的原因。结果 2017年普通外科共发生434例多重耐药,目标监测多重耐药菌主要是大肠埃希菌,占73.50%,且对头孢类抗菌药物和喹诺酮类抗菌药物的耐药比例均较高。病种分布中阑尾炎患者约占61.52%(267/434),且以急性阑尾炎患者为主(125例,46.82%)。年龄集中分布于青、中年患者,65岁以下的患者占88.02%(382/434)。403例(92.86%)为非外伤性疾病,91例(20.97%)存在合并症,307例(70.74%)未更改经验性抗感染治疗方案。结论普通外科多重耐药渐趋明显,其中大肠埃希菌多重耐药率高于全院甚至全国的耐药率,且多重耐药患者的病种和年龄分布异常,其原因可能与医疗机构以及患者不合理使用抗菌药物导致细菌变异有关,同时不排除为本地区畜牧养殖业滥用抗菌药物的原因。更多还原

【Abstract】 Objective To investigate the multiple drug resistance status of general surgery in a tertiary hospital in Guangzhou, to analyze the causes of multiple drug resistance, and provide a reference for the formulation of multiple drug resistance strategies. Methods: Through analyzing the number and proportion of multi-drug resistant bacteria which were target monitored by department of general surgery of Huadu district people’s hospital of Guangzhou in 2017, the disease structure and age distribution of multi-drug resistant patients were analyzed, and the causes of multiple drug resistance were investigated. Results: A total of 434 multi-drug resistant patients occurred in department of general surgery in 2017. The target multi-drug resistant strain was Escherichia coli, accounting for 73.50%, and the resistance rate to cephalosporin antibiotics and quinolones was higher. The appendicitis patients accounted for 61.52%(267/434) of the disease distribution, and mainly for the patients with acute appendicitis(125 cases, 46.82%). The age is mainly distributed in young and middle-aged patients, and about 88.02% of patients were under 65 years old(382/434). 403 cases(92.86%) were non-traumatic diseases, 91 cases(20.97%) had comorbidities, and 307 cases(70.74%) did not change the empirical anti-infective treatment plan. Conclusions: The multi-drug resistance of department of general surgery is becoming gradually obvious, the multi-drug resistance rate of Escherichia coli is significantly higher than that of the whole hospital and even the whole country, and there are disease and age distribution abnormalities in patients with multiple drug resistance. The reason may be related to the bacterial mutation caused by the unreasonable use of antibiotics by medical institutions and patients, and it does not exclude the reasons for the abuse of antibiotics in animal husbandry industry in local area.更多还原