襄阳市中医医院血流感染病原菌的分布与耐药性分析

发布时间：2017-12-28 16:34

本文关键词：襄阳市中医医院血流感染病原菌的分布与耐药性分析　出处：《中国感染与化疗杂志》2016年01期 　论文类型：期刊论文

【摘要】：目的了解医院血流感染病原菌的分布和耐药状况,为临床治疗血流感染提供依据。方法收集襄阳市中医医院2014年1—12月门诊及住院血流感染患者血培养分离的病原菌及药敏试验资料进行回顾性分析。结果血培养共分离病原菌637株,其中以革兰阳性球菌为主,占55.4%;革兰阴性杆菌占44.1%;真菌占0.5%。病原菌检出率排在首位的是凝固酶阴性葡萄球菌,占34.9%;其次为大肠埃希菌,占14.4%;肺炎克雷伯菌,占9.9%;肠球菌属,占9.9%;金黄色葡萄球菌(金葡菌),占8.3%;鲍曼不动杆菌,占7.4%等。血培养葡萄球菌属细菌对青霉素高度耐药,对红霉素、克林霉素耐药率相对较高,对利福平的耐药率相对较低,尚未发现耐万古霉素、替考拉宁、利奈唑胺的菌株。肠球菌属中屎肠球菌的耐药率明显高于粪肠球菌。甲氧西林耐药金葡菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别为47.2%和59.0%。大肠埃希菌和肺炎克雷伯菌对第一、二代头孢菌素耐药率较高,对阿米卡星耐药率较低。产超广谱β内酰胺酶大肠埃希菌和肺炎克雷伯菌检出率分别为50.0%和36.5%。血流感染中鲍曼不动杆菌对亚胺培南的耐药率为51.1%,对米诺环素耐药率为29.7%;铜绿假单胞菌检出比例相对较小,对哌拉西林耐药率较高,对其他抗菌药物耐药率相对较低。结论血培养以革兰阳性球菌为主。应加强对医院血培养病原菌进行耐药监测,掌握其耐药特点,合理使用抗菌药物,防止耐药菌的传播。
[Abstract]:Objective to understand the distribution and drug resistance of pathogenic bacteria of blood flow infection in hospital, and to provide the basis for clinical treatment of blood flow infection. Methods the pathogenic bacteria and drug sensitivity test data of blood culture isolated from outpatients and inpatients in Xiangyang Hospital of traditional Chinese medicine from 1 to December 2014 were collected and analyzed retrospectively. Results 637 strains of pathogenic bacteria were isolated from blood culture, of which gram-positive coccus was mainly gram-positive coccus, accounting for 55.4%, gram-negative bacilli accounted for 44.1%, and fungi accounted for 0.5%. The highest incidence of pathogens was coagulase negative staphylococci (34.9%), followed by Escherichia coli (14.4%), Klebsiella pneumoniae (9.9%), Enterococcus (9.9%), Staphylococcus aureus (Jin Pujun), 8.3%, Acinetobacter baumannii (7.4%), and so on. Staphylococcus aureus is highly resistant to penicillin. The resistance rate to erythromycin and clindamycin is relatively high, and the resistance rate to rifampicin is relatively low. No vancomycin, teicoplanin or linezolid resistant strains have been found. The resistance rate of Enterococcus in Enterococcus is significantly higher than that of Enterococcus faecalis. The detection rates of methoxicillin resistant Staphylococcus aureus (MRSA) and coagulase negative staphylococcus (MRCNS) were 47.2% and 59% respectively. The resistance rate of Escherichia coli and Klebsiella pneumoniae to the first, second generation cephalosporins was higher, and the resistance rate to Amikacin was low. The detection rates of Escherichia coli and Klebsiella pneumoniae produced by broad-spectrum beta lactamases were 50% and 36.5% respectively. In the bloodstream infection, the resistance rate of imipenem to Bauman's Acinetobacter was 51.1%, the resistance rate to minocycline was 29.7%, the proportion of Pseudomonas aeruginosa was relatively small, the resistance rate to piperacillin was high, and the resistance rate to other antibiotics was relatively low. Conclusion the main gram positive cocci are in the blood culture. It should be strengthened to monitor the drug resistance of pathogenic bacteria in hospital blood, grasp the characteristics of drug resistance, use antibiotics reasonably, and prevent the spread of drug-resistant bacteria.
【作者单位】：湖北中医药大学附属襄阳市中医医院检验科;
【分类号】：R446.5
【正文快照】： 血流感染是临床常见严重感染性疾病,起病急、病死率高。为了解我院血流感染病原菌的临床分布及耐药情况。本研究对2014年1—12月门诊及住院患者血培养分离的637株病原菌进行了回顾性分析。现将结果报道如下。1材料与方法1.1材料1.1.1菌株来源收自本院2014年1—12月门诊和住院

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