武汉市某医院革兰阴性菌血流感染的病原体分布及耐药性分析  

The distribution and antimicrobial susceptibility in gram-negative bacteria isolated from bloodstream infection in Renmin hospital of Wuhan University

作　　者：陈浩俊[1] 郭静[1] 李从荣[1] 

机构地区：[1]武汉大学人民医院检验科,湖北武汉430060

出　　处：《现代预防医学》2017年第6期1128-1131,共4页Modern Preventive Medicine

基　　金：国家临床重点专科建设项目(财社[2010]305)

摘　　要：目的调查武汉大学人民医院革兰阴性菌血流感染的病原体分布及耐药现状,为临床医生抗感染治疗提供依据。方法血培养采用Bac T/Alert 3D全自动血培养仪,利用Phoenix-100微生物全自动鉴定药敏仪进行病原体鉴定及药敏试验,按照2013年美国临床实验室标准化协会(CLSI)标准判读结果,采用WHONET5.6和Excel统计分析。结果 2013年3月-2016年3月该院血培养阳性率为7.8%(1938/24735),其中共分离得到822株革兰阴性细菌,占比42.2%。前四位的革兰阴性杆菌分别是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和鲍曼不动杆菌,分别占比51.5%、19.1%、6.4%、4.7%。1株碳青霉烯中介的大肠埃希菌,3株碳青霉烯耐药的肺炎克雷伯菌;铜绿假单胞菌对亚胺培南、美罗培南敏感性分别为83%、90.6%,鲍曼不动杆菌对亚胺培南、美罗培南敏感性分别为18.4%、15.8%。结论大肠埃希菌检出率位列第一,鲍曼不动杆菌耐药严重,临床医生应了解本地区血流感染病原微生物分布以及耐药性,合理用药,减少耐药菌的产生和播散。Objective The aim of this study was to investigate the distribution and antimicrobial susceptibility in gram- negative bacteria isolated from bloodstream infection in Renmin hospital of Wuhan University. Methods BacT /Alert 3D automated blood culture system and Phoenix-lO0 automatic identification of microbial susceptibility system were used to identify and test antimicrobial susceptibility. The standard was followed by 2013 CLSI and the data was analyzed using Whonet 5.6 software and excel. Results Blood culture positive rate was 7.8% （1938/24735） in our hospital from 2013 to 2016 and altogether 822 strains of gram-negative bacteria were detected from bloodstream infection accounting for 42.2%. The top four bacterial species were E. coli, K. pneumoniae, P. aeruginosa and A. baumannii, accounting for 51.5%, 19.1%, 6.4%, 4.7%, respectively. Carbapenem to intermediate E. coli had one strain and carbapenem to resistance K. pneumoniae had three strains. Imipenem and meropenem susceptibility were 83% and 90.6% in P. aeruginosa strains, respectively. Imipenem and meropenem susceptibility were 18.4% and 15.8% in A. baumannii strains, respectively. Conclusion Detection rate of E. coli ranked first and drug resistance was serious in Acinetobacter baumannii. Therefore, the clinicians should adopt an active treatment based on in vitro susceptibility of antibiotics to reduce the prevalence of MDR bacteria.

关 键 词：革兰阴性杆菌 血流感染 分布及耐药性 

分 类 号：R378[医药卫生—病原生物学]