2012—2015年医院血流感染病原菌分布及耐药性变迁  

Changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in 2012-2015

作　　者：徐腾飞[1] 刘志武[1] 金凤玲[1] XU Teng-fei LIU Zhi-wu JIN Feng-ling(The First Hospital of Lanzhou University, Lanzhou 730000, Chin)

机构地区：[1]兰州大学第一医院,甘肃兰州730000

出　　处：《中国感染控制杂志》2017年第10期936-940,共5页Chinese Journal of Infection Control

基　　金：甘肃省科技厅青年科技基金资助项目(1506RJYA261)

摘　　要：目的了解某院2012—2015年血流感染病原菌分布及耐药性变迁特征。方法收集该院2012年1月—2015年12月检验中心微生物室血培养分离病原菌,分为2012—2013年组和2014—2015年组,比较两组菌株的分布特征、构成情况以及对抗菌药物的敏感性。结果两组时间段内分离的病原菌以革兰阴性菌为主,分别占各组菌株的54.96%和54.66%,两组病原菌分布构成比较,差异无统计学意义(P>0.05)。革兰阳性球菌对万古霉素和利奈唑胺敏感性高,耐药率均为0;凝固酶阴性葡萄球菌(CNS)对苯唑西林的耐药率均>80%,对青霉素的耐药性也均>90%;肠杆菌科细菌对亚胺培南、美罗培南的敏感性高,但已出现耐此类药物菌株;两组时间段鲍曼不动杆菌对米诺环素较为敏感,耐药率分别为35.90%和34.55%,对其他药物耐药率均较高(>75%)。结论该院血流感染的病原菌耐药菌检出率高,应引起警惕,加强细菌耐药性监测有利于指导临床合理选择和使用抗菌药物。Objective To investigate the changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in 2012 - 2015. Methods Pathogenic bacteria isolated from blood culture in a hospital microbiology laboratory between January 2012 and December 2015 were collected and divided into 2012 - 2013 group and 2014-2015 group, distribution characteristics, constitute, and antimicrobial susceptibility of two groups were compared. Results Gram-negative bacteria were the main pathogens isolated during two periods, ac- counting for 54.96 % and 54.66 % respectively, there was no significant differences in pathogen distribution between two groups （P〈0.05）. Gram-positive cocci had a high sensitivity to vancomycin and linezolid, resistant rates were both 0% resistance rates of coagulase negative staphylococci to oxacillin were all 80%, resistance to penicillin was also 〉90%; Enterobacteriaceae was highly sensitive to imipenem and meropenem, but resistance strains had ap- peared; Acinetobacter baumannii was sensitive to minocyeline during two periods, resistance rates were 35.90 % and 34.55% respectively, resistance rates to other antimicrobial agents were also high （〉75%）. Conclusion The iso- lation rate of drug-resistant pathogenic strains causing bloodstream infection is high, monitoring on bacterial resistance is helpful for guiding rational use of antimicrobial agents in clinic.

关 键 词：血流感染 病原菌 抗药性 微生物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]