某三甲医院2008-2018年血培养阳性病原菌分布及耐药性分析  

Analysis on distribution and drug resistance of bacteria causing bioodstream infection in a hospital during 2008-2018

作　　者：冯金鑫 康建邦[2] 朱园园 任健 王思扬 李珍 张瑞琴[2] FENG Jinxin;KANG Jianbang;ZHU Yuanyuan;REN Jian;WANG Siyang;LI Zhen;ZHANG Ruiqing(Department of Pharmacy,Shangxi Medical University,Shanxi,Taiyuan 030001,China;Department of Pharmacy,Second Hospital of Shanxi MedicalUniversity,Shanxi,Taiyuan 030001,China)

机构地区：[1]山西医科大学药学院,山西太原030001 [2]山西医科大学第二医院药学部,山西太原030001

出　　处：《国际检验医学杂志》2021年第S01期52-57,共6页International Journal of Laboratory Medicine

基　　金：山西省自然科学基金(201801D121221)。

摘　　要：目的分析2008-2018年间山西医科大学第二医院患者血培养阳性病原菌的分布及耐药性特征,为临床医生合理使用抗菌药物提供思路及科学依据。方法收集2008年1-12月山西医科大学第二医院临床送检血培养标本,采用BACTECTMFX全自动血培养仪进行培养,VITEK 2 COMPACT全自动鉴定药敏分析仪进行病原菌鉴定和药敏试验,并通过WHONET 5.6、SPSS21.0软件进行数据统计分析。结果共分离出病原菌3195株,其中革兰阴性菌占2025株(63.38%),革兰阳性菌占1170株(36.62%),检出率排名前5位依次是大肠埃希菌966株(30.23%)、凝固酶阴性葡萄球菌537株(16.81%)、肺炎克雷伯菌324株(10.14%)、铜绿假单胞菌151株(4.73%)和金黄色葡萄球菌151株(4.73%)。对病原菌进行年龄分组,粪肠球菌在41~65岁组和>65岁组中的检出率比18~40岁组几乎多出一倍,大肠埃希菌,肺炎克雷伯菌和金黄色葡萄球菌在不同年龄组别中的检出率差异有统计学意义(P<0.05)。耐药性监测显示,美罗培南,亚胺培南及阿米卡星对肠杆菌科病原菌有较好的抗菌活性(敏感率>75%);铜绿假单胞菌对抗菌药物的敏感率均高于鲍曼不动杆菌,差异有统计学意义(P<0.05);葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)的分离率为14.30%,低于全国水平;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率是78.00%,与全国2018年MRCNS的检出率相近(78.90%)。屎肠球菌的敏感率低于粪肠球菌,未发现对替考拉宁、万古霉素耐药的阳性球菌。结论医院血流感染以革兰阴性杆菌为主,分离病原菌对抗菌药物的敏感性有各自特点,不同年龄段患者血流感染的病原菌有差异,因此,临床抗感染治疗应根据本院病原菌分布、耐药特征及年龄,合理选择使用抗菌药物,提高抗感染治疗效果。Objective To analyze the distribution and drug resistance characteristics of pathogens with positive blood culture in the second hospital of Shanxi Medical University from 2018 to2018,so as to provide ideas and scientific basis for clinicians to reasonably use antibiotics.Methods Retrospective analysis was conducted on the positive pathogenic bacteria cultured in the blood of our hospital from January 2008 to December 2018.BACTECTMFX automatic blood culture instrument was used for culture,VITEK 2 COMPACT automatic identification drug sensitivity analyzer was used for identification,WHONET 5.6 and SPSS21.0 software were used for statistical analysis.Results A total of 3,195 strains of pathogenic bacteria were isolated,including 2,025 strains(63.38%)of Gram-negative bacteria and 1,170 strains(36.62%)of Gram-positive bacteria.The top five detection rates were 966 strains(30.23%)of Escherichia coli,537 strains(16.81%)of coagulase negative staphylococcus,324 strains(10.14%)of Klebsiella pneumoniae,151 strains(4.73%)of Pseudomonas aeruginosa and 151 strains(4.73%)of Staphylococcus aureus.The pathogens were grouped by age.The detection rate of Enterococcus faecalis in 41-65 years old group and>65 years old group was almost twice as high as that in 18-40 years old group,including Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus,the difference of detection rate in different age groups was statistically significant(P<0.05).Drug resistance monitoring showed that meropenem,imipenem and amikacin had good antibacterial activity against Enterobacteriaceae(sensitivity rate>75.00%);The sensitivity rate of Pseudomonas aeruginosa to antibiotics was higher than that of Acinetobacter baumannii,and the difference was statistically significant(P<0.05);The isolation rate of methicillin-resistant Staphylococcus aureus(MRSA)was 14.30%,lower than the national level;The detection rate of methicillin-resistant coagulase negative staphylococcus(mrcns)was 78.00%,which was similar to that of the national mrcns in 2018(78.90%).Th

关 键 词：病原菌 血流感染 抗菌药物 耐药率 

分 类 号：R44[医药卫生—诊断学]