1938株血流感染病原菌分布与耐药特征分析  

Analysis on distribution and drug resistance characteristics in 1938 strains of blood flow infection pathogenic bacteria

作　　者：卢赞[1] 尹利民[1] 伏改芬[1] 

机构地区：[1]云南省昆明市第一人民医院/甘美国际医院检验科,650011

出　　处：《国际检验医学杂志》2017年第10期1354-1357,共4页International Journal of Laboratory Medicine

摘　　要：目的了解该院血流感染病原菌种类和临床分布特征及药物敏感情况,为临床经验治疗提供依据。方法回顾分析该院2012年1月至2016年8月从血培养中分离到的1 938株病原菌,分析其种类分布、科室分布及药物敏感情况。结果 1 938株病原菌主要由56种细菌和8种真菌构成。革兰阴性菌1 216株,占64.2%,革兰阳性菌677株,占34.9%,真菌45株,占2.4%。分离率前5位的依次是大肠埃希菌628株(32.4%),肺炎克雷伯菌230株(11.9%),沙门氏菌143株(7.4%),表皮葡萄球菌142株(7.3%),人葡萄球菌130株(6.7%)。肠杆菌科细菌共1 098株(58.0%)以大肠埃希菌和肺炎克雷伯菌为主,其中有363(57.8%)株大肠埃希菌和85株(37.0%)肺炎克雷伯菌产超广谱β内酰胺酶(ESBLs)。非发酵菌118株(6.1%),以鲍曼不动杆菌和铜绿假单胞菌为主。金黄色葡萄球菌75株(3.9%),耐甲氧西林金黄色葡萄球菌(MRSA)发生率25.3%,凝固酶阴性葡萄球菌(CoNS)401株(20.7%),耐甲氧西林CoNS(MRCoNS)发生率72.8%。肠球菌85株(4.5%)。阳性率前五位科室为呼吸科、ICU、肝胆科、消化科和血液科,除ICU和儿科外其他科与总体分布一致。鲍曼不动杆菌多数呈多重耐药。未检出耐万古霉素的葡萄球菌和肠球菌,念珠菌对常用抗真菌药保持较好敏感性。结论该院血流感染病原菌分布广泛,常用药物敏感性不同,总体耐药率较高,临床可依据病原菌科室分布及药物敏感特征进行早期用药。Objective To understand the species,clinical distribution features and drug susceptibility situation of bloodstream infection pathogenic bacteria in this hospital to provide reference for clinical empirical treatment.Methods The retrospective analysis was performed on 1 938 strains of pathogenic bacteria isolated from blood culture in our hospital from January 2012 to August2016,their species distribution,department distribution and drug sensitivity were analyzed.Results A total of 1 938 strain of bacteria were comprised of 56 kinds of bacteria and 8kinds of fungi.Gram-negative bacteria had 1 216 strains,accounting for 64.2%,Gram-positive bacteria had 677 strains,accounting for 34.9%,Fungi had 45 strains,accounting for 2.4%.The top 5of isolation rates were Escherichia coli(628strains,32.4%),Klebsiella pneumoniae(230strains,11.9%),Salmonella(143strains,7.4%),Staphylococcus epidermidis(142strains,7.3%)and Staphylococcus hominis(130strains,6.7%).Enterobacteriaceae bacteria had1 098strains(58.0%),which was dominated by Escherichia coli and Klebsiella pneumoniae,in which 363strains(57.8%)were Escherichia coli and 85strains(37.0%)were extended spectrumβlactamases(ESBLs)producing Klebsiella pneumoniae.Nonfermenters had 118strains(6.1%),Acinetobacter baumannii and Pseudomonas aeruginosa were predominant.Staphylococcus aureus had 75strains(3.9%),the MRSA occurrence rate was 25.3%,coagulase-negative staphylococci(CoNS)had 401strains(20.7%),the methicillin-resistant CoNS occurrence rate was 72.8%.Enterococcus had 85strains(4.5%).The top 5departments in positive rates were respiratory department,ICU,hepatobiliary department,gastroenterology department and hematology department.The other departments were consistent to the overall distribution except for ICU and pediatrics.The majority of Acinetobacter baumannii showed multi-drug resistant.Vancomycin-resistant Staphylococcus and Enterococcus did not be detected,Candida maintained good sensitivity to commonly used antifungal agents.Conclusion Bloodstream infection pathogenic b

关 键 词：血流感染 病原菌分布 耐药特征 

分 类 号：R446.5[医药卫生—诊断学]