聊城某医院近5年血培养病原菌的分布与耐药性分析  

Distribution and drug resistance analysis of pathogenic bacteria from blood culture in a hospital of Liaocheng in recent five years

作　　者：王扬 吴玉龙[1] 田金静 康亚丽 房忠卫 WANG Yang;WU Yu-long;TIAN Jin-jing(Binzhou Medical University,Shandong Yantai 252600)

机构地区：[1]滨州医学院,山东烟台264003 [2]聊城市第二人民医院检验科,山东临清252600

出　　处：《医学检验与临床》2021年第10期36-40,共5页Medical Laboratory Science and Clinics

摘　　要：目的:研究该院2016~2020年血培养病原菌的分布特点及耐药性,为临床治疗及合理选择抗菌药物提供依据。方法:分析该院2016~2020年期间临床血培养分离的999株病原菌的药敏结果,按照CLSI2019年标准,使用WHONET5.6软件进行数据分析。结果:革兰阴性菌分离率最高,共670株(67.1%),其次是革兰阳性菌,共317株(31.7%),真菌共12株(1.2%)。血培养分离前五位的细菌分别是大肠埃希菌449株(44.9%),肺炎克雷伯菌97株(9.7%),人葡萄球菌69株(6.9%),金黄色葡萄球菌53株(5.3%),表皮葡萄球菌52株(5.2%)。革兰阴性杆菌中大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、头孢替坦、厄他培南、亚胺培南、美罗培南、阿米卡星的耐药率低均低于5%。耐碳青霉烯类肠杆菌科细菌(CRE)共检出8株(0.8%),其中耐碳青霉烯类的大肠埃希菌(CR-eco)6株,耐碳青霉烯类的肺炎克雷伯菌(CR-kpn)2株,CRE对大多数临床常用抗菌药物呈高度耐药,对阿米卡星、替加环素有较高敏感性。鲍曼不动杆菌对大多数抗菌药物的耐药率均较高,对碳青霉烯类药物耐药率为66.7%,铜绿假单胞菌对多数抗菌药物敏感。耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为45.3%,未发现对万古霉素耐药的葡萄球菌和肺炎链球菌。结论:该院血培养以革兰阴性菌为主,不同病原菌对抗生素的耐药性有一定差异。应充分利用药敏结果进行感染控制,合理选择抗菌药物,减少耐药菌的出现。Objective:To study the distribution and drug resistanc of pathogenic bacteria from blood culture in a hospital of Liaocheng during 2016-2020 to provide evidence for clinical treatment and rational selection of antibacterial agents.Methods:A total of 999 clinical strains collected from blood cultures in a hospital from 2016 to 2020 were analyzed retrospectively.The data were analyzed by WHONET5.6 software according to the clinical and Laboratory Standards Institute(CLSI)2019 breakpoints.Results:The isolation rate of Gram-negative(G-)bacteria is the highist(67.1%,670/999),followed by Gram-positive(G+)bacteria(31.7%,317/999),fungi(1.2%,12/999).The top five populations of the bacteria isolates were E.coli(44.9%,449/999),K.pneumonia(9.7%,97/999),S.hominis(6.9%,69/999),S.aureus(5.3%,53/999),S.epidermidis(5.2%,52/999).E.coli and K.Pneumoniae had low resistance rates to piperacillin/tazobactam,cefoperazone/sulbactam,cefotetan,ertapenem,imipenem,meropenem and amikacin,with the resistance rate of less than 5%.8 strains of Carbapenem-Resistant Enterbacteriacae(CRE)were detected(0.8%),which including 6 strains of Carbapenem-Resistant E.coli(CReco)and 2 strains of Carbapenem-Resistant K.pneumoniae(CR-kpn).CRE strains showed the highest resistance to most commonly used antibiotics,but is sensitive to amikacin and tigecycline.The resistance rate of Acinetobacter baumannii was very high against most antibiotics,of which carbapenems had a resistance of 66.7%.Pseudomonas aeruginosa was sensitive to most antibacterial drugs.The prevalence of methicillin resistant S.aureus(MRSA)was 45.3%,No vancomycin resistant S.aureus and Streptococcus pneumoniae isolates were found.Conclusion:Gramnegative bacteria is a major part of the blood culture in the hospital.The resistance situation is quite different among various pathogens.Antibiotics should be applied reasonably and the control of hospital infection should be strengthened to reduce the emergence of drug-resistant bacteria.

关 键 词：血培养 耐药性分析 病原菌 

分 类 号：R44[医药卫生—诊断学]