血流感染病原菌分布及耐药性分析单中心研究  

Analysis of bacterial distribution and antimicrobial resistance in bloodstream infection : a retrospective single center study

作　　者：邓丽[1,2] 张新霞[1,2] 张立平[1,2] 朴文花[1,2] 

机构地区：[1]宁夏人民医院检验科,宁夏银川750002 [2]西北民族大学第一附属医院,宁夏银川750002

出　　处：《宁夏医学杂志》2017年第1期53-55,共3页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ16195)

摘　　要：目的探讨血流感染的病原菌临床分布和耐药性。方法收集临床分离血流感染病原菌,细菌鉴定使用VITEK-2 Compact全自动微生物分析仪,用纸片扩散法检测细菌耐药性,应用Whonet 5.6软件进行统计分析。结果临床引起血流感染前5位病原菌,依次为凝固酶阴性葡萄球菌(33.9%)、大肠埃希菌(25.6%)、肺炎克雷伯菌(8.9%)、肠球菌属(6.1%)和金黄色葡萄球菌(5.4%),主要以40岁以上患者多见;未检测到耐万古霉素的葡萄球菌和肠球菌,大肠埃希菌和鲍曼不动杆菌对抗菌药物耐药率均高于40.0%,肺炎克雷伯菌和铜绿假单胞菌对抗菌药物耐药率都低于30.0%。结论血流感染病原菌对各类抗菌药物呈现不同程度的耐药,定期监测可为临床医生提供诊疗依据。Objective To investigate the distribution and resistance of bacterial isolates in order to provide evidence for clinical diagnosis and treatment. Methods The bacterial isolates were collected and identified by the VITEK- 2 Compact automatic microorganism analyzer and susceptibility testing by the disk diffusion method（ K- B）. The software whonet 5. 6 was used for statistical analysis. Results Totally757 strains of pathogenic bacteria were isolated,the highest department detection rate of the intensive care units（ ICUs） was 20. 5%,followed by the pediatric department（ 19. 3%） and respiratory department（ 6. 5%）. The top five pathogenic bacteria were coagulase- negative staphylococcus（ 33. 9%）,Escherichia coli（ 25. 6%）,Klebsiella pneumoniae（ 8. 9%）,Enterococcus spp.（ 6. 1%） and Staphylococcus aureus（ 5. 4%）.Coagulase- negative staphylococcus bloodstream infections mainly occurred in the pediatric department. Escherichia coli and Klebsiella pneumoniae bloodstream infections mainly occurred in the ICU and the hematology department,patients over age 40 years were the majority. Vancomycin- resistant Staphylococcus and Enterococcus was not detected. The resistance rates of escherichia coli to a variety of antibacterials were all above 40. 0%. The resistance rates of Klebsiella pneumoniae to a variety of antimicrobial were less than 30. 0%. The resistance rate of acinetobacter Baumannii to minocycline was lower（ 4. 0%）. The resistance rate of Pseudomonas aeruginosa to antibacterials were less than 30. 0%.Conclusion Bloodstream infection mainly occurred in the ICUs,pediatric and respiratory medicine,topped with coagulase- negative staphylococci. The status of bacterial resistance showed different kinds,so regular surveillance of bacterial resistance can provide scientific basis for clinical diagnosis and treatment.

关 键 词：血流感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]