2008—2014年中国南方某综合性医院血流感染病原菌构成及耐药性分析

发布时间：2018-04-29 00:28

本文选题：血流感染 + 病原菌　；参考：《中国抗生素杂志》2016年10期

【摘要】：目的了解福州地区血流感染病原菌分布及耐药状况,为临床合理应用抗菌药物提供依据。方法回顾性分析本医院2008年1月—2014年12月临床送检的血培养标本病原菌构成及耐药性。药物敏感性试验采用MIC或KB纸片法,按CLSI规定的标准执行;应用WHONET5.6软件分析病原菌的种类及耐药状况。结果 7年间从临床送检的血培养标本中共培养分离获得4292株病原菌,其中革兰阴性菌2667株(占62.14%),革兰阳性菌1353株(占31.52%),真菌272株(占6.34%)。排前三位的病原菌为大肠埃希菌、凝固酶阴性葡萄球菌和肺炎克雷伯菌。主要来源的科室为血液科、重症医学科和门诊患者。产ESBLs的大肠埃希菌和肺炎克雷伯菌平均检出率分别为57.46%和24.77%,对亚胺培南的耐药率:肺炎克雷伯菌为7.98%并呈上升趋势,阴沟肠杆菌为9.58%,铜绿假单胞菌为23.66%,鲍曼不动杆菌为38.10%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和金黄色葡萄球菌(MRSA)检出率分别为81.00%和38.60%;未发现对万古霉素、利奈唑胺及替加环素耐药的葡萄球菌。粪肠球菌和屎肠球菌对万古霉素的耐药率分别为0.66%和5.21%。结论本地区血流感染病原菌以革兰阴性菌为主,但应重视真菌的感染,针对性的合理使用抗菌药物。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in blood stream infection in Fuzhou, and to provide evidence for rational use of antimicrobial agents. Methods the pathogenic bacteria composition and drug resistance of blood culture samples from January 2008 to December 2014 in our hospital were analyzed retrospectively. The drug sensitivity test was carried out by MIC or KB paper method according to the standard prescribed by CLSI, and the species and drug resistance of pathogens were analyzed by WHONET5.6 software. Results A total of 4292 strains of pathogenic bacteria were isolated from clinical blood culture specimens during the past seven years. Among them, 2667 strains were Gram-negative bacteria (62.14%), 1353 strains were Gram-positive bacteria (31.52%), and 272 strains were fungi (6.34%). The top three pathogens were Escherichia coli, coagulase-negative staphylococcus and Klebsiella pneumoniae. The main sources of departments are hematology, intensive medicine and outpatients. The average detection rates of Escherichia coli and Klebsiella pneumoniae producing ESBLs were 57.46% and 24.77%, respectively. The drug resistance rate of Klebsiella pneumoniae was 7.98% and increased, Enterobacter cloacae 9.58, Pseudomonas aeruginosa 23.66 and Acinetobacter baumannii 38.100.The average detection rate of Escherichia coli and Klebsiella pneumoniae were 57.46% and 24.77%, respectively. The positive rates of methicillin-resistant coagulase-negative staphylococci (MRCNS) and staphylococcus aureus (MRSAs) were 81.00% and 38.60%, respectively, and no vancomycin, linazolamide and tegacycline resistant staphylococci were found. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.66% and 5.21%, respectively. Conclusion Gram-negative bacteria are the main pathogens of blood flow infection in this area, but we should pay attention to fungal infection and use antibiotics rationally.
【作者单位】：福建卫生职业技术学院;福建医科大学附属协和医院;
【基金】：福建省卫生厅青年科研资助项目(No.2009-1-20) 福建省教育厅中青年科研项目(No.JB14204)
【分类号】：R446.5

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