昆明某医院血培养病原菌分布与耐药性研究  

Study on the distribution and drug resistance of pathogenic bacteria in blood culture in a hospital in Kunming

作　　者：伏改芬[1] 尹利民 卢赞[1] 李代碧 许婷 FU Gaifen;YIN Limin;LU Zan;LI Daibi;XU Ting(Department of Clinical Laboratory,Kunming Municipal First People′s Hospital/Ganmei Hospital,Kunming,Yunnan 650011,China)

机构地区：[1]云南省昆明市第一人民医院/甘美医院检验科,云南昆明650011

出　　处：《检验医学与临床》2021年第10期1413-1416,共4页Laboratory Medicine and Clinic

摘　　要：目的分析该院血培养阳性标本病原菌分布特点及耐药性,为临床合理应用抗菌药物提供参考依据,降低细菌耐药性。方法对2017-2019年血培养阳性病原菌的分布情况及耐药性进行回顾性分析。结果血培养阳性非重复性标本共分离出病原菌985株,其中革兰阴性菌622株,占63.15%,革兰阳性菌341株,占34.62%,真菌22株,占2.23%。革兰阴性菌中排名前3位依次是大肠埃希菌、肺炎克雷伯菌(肺炎亚种)、铜绿假单胞菌。产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌检出率分别为53.73%和16.84%,大肠埃希菌未发现对碳青霉烯类耐药。肺炎克雷伯菌对碳青霉烯类耐药率均<15.00%。铜绿假单胞菌对常用抗菌药物耐药率均<40.00%。革兰阳性菌以凝固酶阴性葡萄球菌为主,占11.17%(110/985),耐甲氧西林金黄色葡萄球菌占22.00%。未发现对万古霉素、替加环素和替考拉宁耐药的葡萄球菌。肠球菌属中屎肠球菌对青霉素G的耐药率(93.80%)明显高于粪肠球菌(4.8%),未发现对利奈唑胺、替加环素、万古霉素耐药的肠球菌。结论 2017-2019年该院临床血培养阳性的病原菌以革兰阴性菌为主,定期进行血流感染监测有利于指导临床合理选择和使用抗菌药物。Objective To analyze the distribution characteristics and drug resistance of pathogens in positive blood culture specimens in the hospital,and thus to provide a reference for the rational use of antimicrobial drugs in clinical practice and reduce the drug resistance of bacteria.Methods A retrospectively analysis was performed for the distribution and drug resistance of pathogens in positive blood culture specimens collected from January 2017 to December 2019.Results A total of 985 types of pathogens were isolated from non-repetitive positive blood culture specimens,including 622 Gram-negative bacteria,accounting for 63.15%,341 Gram-positive bacteria,accounting for 31.62%,and 22 fungi,accounting for 2.23%.Among the Gram-negative bacteria,the top three pathogens were Escherichia coli,Klebsiella pneumoniae subspecies,and Pseudomonas aeruginosa.The detection rates of extended-spectrumβ-lactamase-producing Escherichia coli and ESBLS-producing Klebsiella pneumoniae were 53.73%and 16.84%,respectively.Resistance of Escherichia coli to carbapenems was not observed,while the resistance rate of Klebsiella pneumoniae to carbapenems was less than 15.00%.The resistance rates of Pseudomonas aeruginosa to commonly used antibacterial drugs were all less than 40.00%.Among the Gram-positive bacteria,coagulase-negative Staphylococci was the most common pathogen observed accounting for 11.17%(110/985),among which the incidence rate of methicillin-resistant Staphylococcus aureus was 22.00%.Resistance of Staphylococci to vancomycin,tigecycline or teicoplanin was not found.Among the Enterococcus genus,the resistance rate of Enterococcus faecium to penicillin(93.80%)was significantly higher than that of Enterococcus faecalis(4.8%).Resistance of Enterococcus to linezolid,tigecycline and vancomycin was not found.Conclusion The pathogens isolated from positive blood culture specimens in the hospital from 2017 to 2019 are mainly Gram-negative bacteria.Regular bloodstream infection monitoring is supposed to be helpful to guide the rational s

关 键 词：血培养 血流感染 耐药性 

分 类 号：R446.1[医药卫生—诊断学]