大庆油田总医院呼吸科血流感染病因学及病原学研究  

Etiology and Pathogeny of Bloodstreami Infection in Respiratory Department of Daqing Oilfield General Hospital

作　　者：顾国忠[1] 张灵宇[1] 周艳[1] 袁峰 宋振明 朱英娟 王春媛[1] 许岩[2] GU Guo-zhong;ZHANG Ling-yu;ZHOU Yan(Daqing First Hospital Department of Respiration,Daqing 163001,Heilongjiang Province)

机构地区：[1]大庆油田总医院(大庆市第一医院)呼吸科,黑龙江大庆16300 [2]吉林大学第一医院,吉林长春130021

出　　处：《中国实验诊断学》2020年第2期241-245,共5页Chinese Journal of Laboratory Diagnosis

摘　　要：目的分析住院患者血流感染致病原因及病原菌种类及耐药性。方法选择2017年10月-2018年9月医院呼吸科161位住院患者血液培养阳性标本中分离178株致病菌,分析其致病原因,病原菌分布及药物敏感试验。结果男性107例,年龄69.87±13.98岁;女性54例,年龄71.48±12.89岁,主要病因为细菌性肺炎69例(38.12%);坠积性肺炎38例(20.99%);感染性发热22例(12.15%);泌尿系感染18例(9.94%);肝脓肿11例(6.08%);其余23例(12.71%)。治愈86例,好转31例,未愈18例,死亡26例;病原学获178株阳性致病菌结果,其中革兰阴性菌93株,其中大肠埃希菌36株,肺炎克雷伯杆菌29株,其余28株,呋喃妥因、替加环素、厄他培南、亚胺培南对大肠埃希菌及产超广谱酶大肠埃希菌均敏感,替加环素亚胺培南及美罗培南对肺炎克雷伯菌及产超广谱酶肺炎克雷伯杆菌均敏感;革兰阳性菌79株,其中表皮葡萄球菌16株,人葡萄球菌人亚种12株,藤黄微球菌9株,金黄色葡萄球菌9株,其余33株;喹奴普汀/达福普汀、利奈唑胺、替加环素及万古霉素对产酶及不产酶表皮葡萄球菌、人葡萄球菌人亚种金黄色葡萄球菌以及藤黄微球菌均敏感;厌氧菌6株。结论医院呼吸科血流感染患者以老年性为主,主要病因为细菌性肺炎及坠积性肺炎,致病细菌以大肠埃希菌及肺炎克雷伯杆菌为主,表皮葡萄球菌及人葡萄球菌人亚种也较多见。Objective To analyze the causes of bloodstreami infection in hospitalized patients and the types and drug resistance of pathogens.Methods 171 strains of pathogenic bacteria were isolated from 161 blood culture positive samples of hospitalized patients in the respiratory department of the hospital from October 2017 to September 2018,and their pathogenic diseases,distribution of pathogenic bacteria and drug sensitivity tests were analyzed.Results There were 107 males,aged 69.87±13.98 years;54 females,aged 71.48±12.89 years,with 69 cases(38.12%)of bacterial pneumonia;38 cases(20.99%)of hypoplastic pneumonia;22 cases(12.15%)of infectious fever;18 cases(9.94%)of urinary tract infection;11 cases(6.08%)of liver abscess;and 23 cases(12.71%).86 cases were cured,31 cases were improved,18 cases were not cured and 26 cases died.Pathogenic results:93 strains of Gram-negative bacteria,including36 strains of Escherichia coli,29 strains of Klebsiella pneumoniae,the remaining 28 strains,furantoin,tegacycline,ertapenem,imipenem were sensitive to Escherichia coli and extended-spectrum enzyme-producing Escherichia coli,and tegacycline imipenem and meropenem were sensitive to Klebsiella pneumoniae.The bacteria and Klebsiella pneumoniae producing extended-spectrum enzymes were sensitive;79 strains of Gram-positive bacteria,including 16 strains of Staphylococcus epidermidis,12 strains of Staphylococcus human subspecies,9 strains of Micrococcus luteus,9 strains of Staphylococcus aureus and the rest 33 strains;Quinopristine/Dafoptine,linezolid,tegacycline and vancomycin were sensitive to enzymatic and non-enzymatic Staphylococcus epidermidis and human subspecies of Staphylococcus aureus.Staphylococcus chromophorus and Micrococcus luteus were sensitive;anaerobic bacteria were 6 strains.Conclusion The main causes of nosocomial respiratory infection are bacterial pneumonia and hypoplastic pneumonia.Escherichia coli and Klebsiella pneumoniae are the main pathogenic bacteria.Staphylococcus epidermidis and Staphylococcus human subspecies are

关 键 词：血流感染 病因学 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]