2011-2016年我院1775株血流感染病原菌构成及其耐药性分析

发布时间：2018-05-23 22:02

本文选题：血流感染 + 血培养　；参考：《中国药房》2017年29期

【摘要】：目的:为临床合理使用抗菌药物提供参考。方法:收集我院2011年1月-2016年12月住院患者的血培养阳性标本,回顾性分析我院血液感染(BSI)病原菌分布及耐药情况。结果:2011-2016年,我院住院患者共送检血培养标本26 034份,其中阳性标本1 775份,总阳性率为6.82%;主要来源于肿瘤、血液科(10.65%),神经外科(8.28%)和儿科(8.00%)。共检出病原菌1 775株,包括以大肠埃希菌、肺炎克雷伯菌为主的革兰氏阴性菌967株(54.48%),以凝固酶阴性葡萄球菌、金黄色葡萄球菌为主的革兰氏阳性菌649株(36.56%)和以白色念珠菌为主的真菌159株(8.96%)。大肠埃希菌和肺炎克雷伯菌对常用抗菌药物均存在不同程度的耐药性,但对哌拉西林钠他唑巴坦钠、亚胺培南、美罗培南较敏感;鲍曼不动杆菌对含酶抑制剂类、头孢菌素类、氨基糖苷类、喹诺酮类药物的耐药率均较高;铜绿假单胞菌对第三代头孢菌素类、氨基糖苷类、喹诺酮类药物较敏感。金黄色葡萄球菌对青霉素类、头孢菌素类、氨基糖苷类药物的耐药率较高;凝固酶阴性葡萄球菌对大部分常用抗菌药物的耐药率均超过40%;但两者对利奈唑胺、万古霉素敏感,耐药率均为0。共检出产超广谱β-内酰胺酶(ESBLs)大肠埃希菌205株(42.01%)、产ESBLs肺炎克雷伯菌64株(30.33%)、耐甲氧西林金黄色葡萄球菌31株(17.61%);未检出耐万古霉素肠球菌和耐万古霉素金黄色葡萄球菌。结论:我院BSI病原菌主要分布在肿瘤、血液科等科室,以肠杆菌科细菌、葡萄球菌为主,真菌也占一定比例,其耐药及产酶情况不容乐观。对主要病原菌较敏感的抗菌药物包括碳青霉烯类、利奈唑胺和万古霉素等。
[Abstract]:Objective: to provide reference for rational use of antimicrobial agents in clinic. Methods: the positive samples of blood culture from January 2011 to December 2016 in our hospital were collected and the distribution and drug resistance of BSIpathogenic bacteria in our hospital were analyzed retrospectively. Results from 2011 to 2016, 26 034 blood culture specimens were examined in our hospital, of which 1,775 were positive, the total positive rate was 6.82, mainly from tumor, hematology 10.65, neurosurgery 8.28) and paediatrics 8.00. A total of 1,775 strains of pathogenic bacteria were detected, including Escherichia coli, Klebsiella pneumoniae 967 strains of Gram-negative bacteria and coagulase negative staphylococcus. There were 649 Gram-positive strains of Staphylococcus aureus and 159 strains of Candida albicans. Escherichia coli and Klebsiella pneumoniae were resistant to common antimicrobial agents to varying degrees, but sensitive to piperacillin sodium, tazobactam sodium, imipenem, meropenem, Acinetobacter baumannii to enzyme inhibitors, cephalosporins, The resistance rates of aminoglycosides and quinolones were higher, and Pseudomonas aeruginosa was more sensitive to the third generation cephalosporins, aminoglycosides and quinolones. Staphylococcus aureus showed higher resistance to penicillin, cephalosporins and aminoglycosides; coagulase-negative staphylococci were resistant to most commonly used antibiotics more than 40; but both were sensitive to linazolamine and vancomycin. The drug resistance rate was 0. A total of 205 strains of Escherichia coli producing extended-spectrum 尾 -lactamases, 64 strains of Klebsiella pneumoniae and 31 strains of methicillin-resistant Staphylococcus aureus were detected, and no vancomycin resistant Enterococcus and vancomycin resistant Staphylococcus aureus were detected. Conclusion: the pathogenic bacteria of BSI are mainly distributed in tumor, hematology and other departments. Enterobacteriaceae and staphylococcus are the main pathogens, fungi also account for a certain proportion, its drug resistance and enzyme production are not optimistic. Antimicrobial agents sensitive to major pathogens include carbapenem, linazolamine and vancomycin.
【作者单位】：乐山市人民医院感染科;
【分类号】：R446.5

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