2015—2019年齐齐哈尔市第一医院血流感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogenic bacteria blood culture in the first hospital of Qiqihaer from 2015 to 2019

作　　者：冯春晓 刘丽 白光锐 王雁 郭海鹏 左晶晶 Feng Chun-xiao;Liu Li;Bai Guang-rui;Wang Yan;Guo Hai-peng;Zuo Jing-jing(The First Hospital of Qiqihaer,Qiqihaer 161005)

机构地区：[1]齐齐哈尔第一医院检验科,齐齐哈尔161005

出　　处：《中国抗生素杂志》2021年第12期1143-1147,共5页Chinese Journal of Antibiotics

摘　　要：目的了解齐齐哈尔市第一医院血流感染患者的细菌分布及其对抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法对齐齐哈尔市第一医院2015年1月—2019年12月从血液标本中分离的细菌分布情况和药物敏感试验结果进行回顾性分析,按照美国临床和实验室标准化委员会(CLSI)2018年标准判读实验结果,使用WHONET 5.6软件统计分析。结果12440份血培养标本中共分离细菌1356株,阳性率为10.90%,其中革兰阴性菌769株,占56.71%,革兰阳性菌587株,占43.29%。排在前6位的细菌依次为大肠埃希菌、肺炎克雷伯菌、人葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌、溶血葡萄球菌,分别占27.73%、15.71%、10.18%、9.81%、6.34%和3.17%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为30.23%和81.16%。未发现对万古霉素和利奈唑胺耐药的葡萄球菌。大肠埃希菌和肺炎克雷伯菌的ESBL检出率分别为28.19%和20.66%。肠杆菌科细菌对碳青霉烯类抗菌药物仍高度敏感,耐药率均低于12%。结论血培养检出病原菌菌谱一般较广,不同细菌间耐药性有广泛差异,病区分布以ICU为主,应加强监测,规范抗菌药物的合理使用。Objective To investigate the distribution and antimicrobial susceptibility of the bacteria isolated from bloodstream infections during 2015—2019 in the First Hospital of Qiqihaer for rational use of antibacterial agents.Methods The distribution and the results of antimicrobial susceptibility testsand characteristics of the pathogenic bacteria isolated from blood culture samples from Jan 2015 to Dec 2019 in the First Hospital of Qiqihaer were retrospectively analyzed.The results were analyzed with WHONET 5.6 software according to the Clinical and Laboratory Standards Institute CLSI 2018 breakpoints.Results A total of 1,356 strains were isolated from the 12,440 sample of blood cultures,the positive rate was 10.90%,including 769(56.71%)Gram-negative bacterial strains,587(43.29%)Gram-positive bacterial strains.Escherichia coli(27.73%)was the most frequently isolated bacteria,followed by Klebsiella pneumoniae(15.71%),Staphylococcus hominis ss.Hominis(10.18%),Staphylococcus epidermidis(9.81%),Staphylococcus aureus(6.34%),and Staphylococcus haemolyticus(3.17%).About 30.23%of the Staphylococcus aureus isolates were identified as MRSA,and 81.16%of the coagulase negative Staphyococcus isolates were identified as MRCNS.No staphylococcal strain was resistant to vancomycin or linezolid.The prevalence of ESBLs was 28.19%in E.coli and 20.66%in Klebsiella pneumoniae.Enterobacteriaceae isolates were still highly susceptible to carbapenems,and the resistance rate was lower than 12%.Conclusion The pathogens isolated from blood culture were diverse.The resistance rates of different bacteria varied widely.The pathogens were mainly found in ICU,monitoring should be strengthened to standardize the rational use of antibiotics.

关 键 词：血培养阳性 耐药性 临床分离菌 

分 类 号：R978.1[医药卫生—药品]