老年菌血症患者感染细菌分布情况及其耐药性分析  

The surveillance of clinical distribution and drug resistance phenotype in elderly patients with bacteremia

作　　者：黄忠团[1] 肖亚雄[1] 陈朴[1] 雷江[1] 刘影[1] 沈伟[1] 龙琴[1] 唐灵通[1] 

机构地区：[1]四川省宜宾市第一人民医院检验科,四川宜宾644600

出　　处：《国际检验医学杂志》2013年第22期2969-2971,共3页International Journal of Laboratory Medicine

基　　金：宜宾市科技局重点科技计划资助项目(2012SF005)

摘　　要：目的了解老年菌血症患者细菌感染分布情况及其耐药表型分析，为临床合理使用抗菌药物提供依据。方法对宜宾市第一人民医院2010～2012年老年菌血症患者感染细菌分布及其耐药性进行回顾性分析。菌种鉴定及药敏采用全自动微生物鉴定仪完成，并对结果进行统计分析。结果1153份全血标本分离出107株细菌和11株真菌，未发现双重感染，其中以肠杆菌科细菌ETS株（63．56％）]最多；患者分布于临床各科室，其中内科78例，外科40例；75株肠杆菌科细菌中，发现产超广谱13-内酰胺酶24株（32．00％），肠杆菌科细菌对于氨苄西林耐药率最高（78．7％），对复方磺胺甲嗯唑耐药率为50．7％，对其他抗菌药物耐药性较低。真菌对临床常用抗真菌药物全部敏感。非发酵菌对于呋喃类，头霉素类、一代头孢、复方磺胺甲噫唑、含酶抑制剂（氨苄西林／舒巴坦）耐药率较高，对其他抗菌药物较敏感。除红霉素、青霉素、四环素外，葡萄球菌对其他抗菌药物耐药率均在50％以下。结论该院老年菌血症患者以肠杆菌科细菌大肠埃希菌感染最为常见，定期监测老年菌血症感染细菌分布及耐药发展趋势对于指导临床用药至关重要。Objective To provide references to clinical application of antibiotics by analyzing the clinical distribution and resistance phenotype in elderly patients with bacteremia. Methods The identification of bacteria and susceptibility tests were per- formed by using automatic bioanalysis. The data of resistance phenotype were analyzed by statistics software. Results There were 107 bacteria strains and 11 fungi strains detected from 1 153 blood samples. Double infection samples didnrt be found. There were 75 strains of Enterobacteriaceae（ 63. 56 % ）. Patients distributed in the clinical departments,with 78 cases in medical department and 40 cases in surgical department, respectively. There were 24 （32 %） ESBLs（＋） strains detected from 75 strains of Enterobacteri- aceae. The ampicillin resistance rate was up to 78.7 %, and the resistance rate of cotrimoxazole was up to 50.7 %. The resistance rates were low in other antibiotic in Enterobacterfaceae. Fungi were remain sensitive to antifungal drugs. Non-fermentative bacteria had high resistance rates to furans, cephamycins generation cephalosporins, cotrimoxazole, including enzyme inhibitors（ampicillin/ sulbactam）. The resistance rates of erythromycin, penicillin, tetracycline in Staphylococcus were higher than 50 %, but the resistance rates of other antibiotis were low. Conclusion Escherichia coli is the most common infectious bacteria in elderly patients with bac- teremia in the hospital. It is important for clinical treatment to monitor the spectra and drug resistance characteristic of infectious bacteria in elderly patients with bacteremia.

关 键 词：老年人 细菌感染 菌血症 耐药表型 

分 类 号：R446.5[医药卫生—诊断学]