目的 分析克拉瑪依市中心醫(yī)院2017—2020年住院患者常見分離菌分布及耐藥率的變遷情況，為指導(dǎo)抗菌藥物臨床合理應(yīng)用提供依據(jù)。方法 收集2017—2020年克拉瑪依市中心醫(yī)院住院患者抗菌藥物使用情況及分離菌，分析主要分離菌對(duì)常見抗菌藥物的耐藥率變化趨勢(shì)。結(jié)果 2017—2019克拉瑪依市中心醫(yī)院抗菌藥物使用率和使用強(qiáng)度呈下降趨勢(shì)，4年共有分離菌12 135株，其中革蘭陽(yáng)性菌2 567株，占21.15%；革蘭陰性菌6 310株，占52.00%；真菌3 258株，占26.85%。居前5位的分離菌分別是白色假絲酵母菌（19.59%）、大腸埃希菌（16.84%）、肺炎克雷伯菌（13.33%）、鮑曼不動(dòng)桿菌（8.71%）和銅綠假單胞菌（7.94%）。主要分離菌對(duì)常用抗菌藥物耐藥率總體呈下降趨勢(shì)，腸桿菌科細(xì)菌對(duì)臨床常用抗菌藥物耐藥性下降最明顯。結(jié)論 克拉瑪依市中心醫(yī)院分離菌逐年增加，耐藥率有下降趨勢(shì)，抗菌藥物臨床應(yīng)用基本合理，但需完善真菌檢測(cè)能力。

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.

R978.1

科技援疆促合理用藥-構(gòu)建抗菌藥物科學(xué)化管理（AMS）體系（2020YFQ0010）