698株血流感染病原菌分布特征及耐药性分析  

Distribution and drug resistance analysis of 698 strains of bloodstream infection pathogens

作　　者：田瑞卿 史彦奎[2] 陈爱地[1] 王卫红[1] 杨胜春 孟庆彩 TIAN Rui-qing;SHI Yan-kui;CHEN Ai-di;WANG Wei-hong;YANG Sheng-chun;MENG Qing-cai(Department of Laboratory,Baoding NO.1 Hospital,Hebei Province,Baoding 071000,China;Department of Laboratory,Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]河北省保定市第一医院检验科,河北保定071000 [2]河北大学附属医院检验科,河北保定071000

出　　处：《河北医科大学学报》2018年第8期949-953,共5页Journal of Hebei Medical University

基　　金：保定市科学技术研究与发展指导计划(17ZF017)

摘　　要：目的分析河北省保定市第一医院患者血流感染的病原菌分布特征及其耐药性,为临床选择有效抗菌药物治疗感染提供参考依据。方法对2014—2016年保定市第一医院患者血培养结果进行分析,收集所分离的病原菌,采用VITEK 2Compact全自动微生物分析系统进行细菌鉴定及药物敏感性试验,并对结果进行分析。结果2014—2016年全院血培养5 020份,分离到病原菌698株(13.90%)。其中革兰阴性杆菌417株(59.74%),以大肠埃希菌和肺炎克雷伯菌为主;革兰阳性球菌221株(31.66%),以凝固酶阴性葡萄球菌为主。血培养阳性率较高的科室依次为消化内科、泌尿外科和重症医学科。大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦、头孢替坦、阿米卡星、亚胺培南和美罗培南的耐药率相对较低。结论大肠埃希菌和肺炎克雷伯菌等革兰阴性杆菌是引起保定市第一医院患者血流感染的主要病原菌,凝固酶阴性葡萄球菌的分离率也较高,临床应重视血培养标本送检和细菌耐药监测,合理使用抗菌药物,以延缓耐药菌株的产生。Objective To analyze the distribution characteristics and drug resistance of pathogens in patients with bloodstream infection from Baoding NO.1 Hospital,and to provide reference for selecting effective antibiotics to treat infection.Methods Blood culture results from Baoding NO.1 Hospital on 2014-2016 were analyzed,the isolated pathogens were collected using VITEK2 Compact automatic microbial analysis system for bacteria identification and antimicrobial susecptibility test,and the results were analyzed.Results A total of 698 strains were isolated from 5 020 blood samples,the positive rate was 13.90%,including 417 strains of gram-negative bacillus,accounted for 59.74%,with Escherichia coli and Klebsiella pneumonia,and 221 strains of gram-positive coccus, accounted for 31.66% of coagulase negative staphylococci.Higher blood culture positive rate was followed by digestive medicine,urology and ICU.Escherichia coli and Klebsiella pneumoniae showed relatively low resistants to piperacillin/tazobactam,cefotetan,Amikacin,imipenem and meropenem.Conclusion Escherichia coli and Klebsiella pneumoniae of gram-negative bacillus are the main pathogenic bacteria in patients with bloodstream infection from Baoding NO.1 Hospital.Coagulase negative staphylococcus separation rate is higher,clinicians should pay attention to blood culture specimens and bacterial drug resistance monitoring,and to use antibiotics rationally for delaying the generation of drugresistant strains.

关 键 词：细菌感染 血培养 耐药率 

分 类 号：R378[医药卫生—病原生物学]