2018~2020年大理市某医院奇异变形杆菌临床分布及耐药性分析
Clinical Distribution and Drug Resistance Analysis of Proteus mirabilis in a Hospital in Dali City, 2018~2020

目的：分析大理大学第一附属医院近三年奇异变形杆菌临床分布及耐药情况，为临床诊断及合理用药提供理论依据。方法：收集2018年1月~2020年12月我院153株奇异变形杆菌院内感染患者的临床数据，分析其临床分布及耐药情况。结果：共分离153株奇异变形杆菌，标本主要来源于分泌物及中段尿(占72.40%)，科室主要来源于泌尿科及烧伤整形科(占34.5%)，年龄≤1岁的患儿占0%，2~18岁(含18岁)占1.8%，18~60岁(含60岁)患者占57.30%，>60岁的患者占40.90%。奇异变形杆菌对呋喃妥因、四环素的耐药率高(97.44%~100.00%)，对美罗培南的耐药率低(0.00%~2.20%)，未发现对阿米卡星耐药的奇异变形杆菌。结论：奇异变形杆菌主要分离于分泌物及中段尿，感染病例主要分布于泌尿科及烧伤整形科，年龄18~60岁(含60岁)是感染的主要年龄段，奇异变形杆菌对美诺培南、氨曲南、头孢吡肟、头孢美唑、头孢西丁、头孢西丁的耐药率较低且处于相对稳定水平，因此抗菌药物可作为临床治疗的抗感染药物。
Objective: To analyze the clinical distribution and drug resistance of Proteus mirabilis in the First Affiliated Hospital of Dali University in the past three years to provide theoretical basis for clinical diagnosis and rational drug use. Methods: The clinical data of 153 nosocomial infections of Proteus mirabilis in our hospital from January 2018 to December 2020 were analyzed for their clinical distribution and drug resistance. Results: A total of 153 strains of Proteus mirabilis were isolated, and the specimens mainly originated from secretions and middle urine (72.40%), the departments mainly originated from urology and burn orthopedics (34.5%), children aged ≤1 year accounted for 0%, 2 to 18 years (including 18 years) accounted for 1.8%, patients aged 18 to 60 years (including 60 years) accounted for 57.30%, patients aged >60 years accounted for 40.90%, high resistance rate of Proteus mirabilis to FT and TE (97.44%~100.00%), low resistance rate to MPN (0.00%~2.20%), and no Proteus mirabilis resistant to AN were found. Conclusions: Proteus mirabilis was mainly isolated from secretions and middle urine, the infection cases were mainly distributed in urology and burn orthopaedics, aged 18~60 years (including 60 years) was the main age group of infection, the resistance rate of Proteus mirabilis to menopenem, aminotransferase, cefepime, cefmetazole, cefoxitin and cefoxitin was low and at a relatively stable level, therefore the antibacterial drugs could be used as clinical treatment for anti-infective drugs.