泌尿外科住院病人血培养病原菌分布及耐药性分析  

AN ANALYSIS OF DISTRIBUTION AND DRUG RESISTANCE OF PATHOGENS IN BLOOD CULTURE OF INPATIENTS IN DEPARTMENT OF UROLOGY

作　　者：刘帅[1] 黄俊蕾 丛培珊[3] 官丰菊[1] 张桂铭[1] LIU Shuai;HUANG Junlei;CONG Peishan;GUAN Fengju;ZHANG Guiming(Department of Urology,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院泌尿外科,山东青岛266003 [2]青岛市城阳区第二人民医院外科 [3]青岛大学附属医院检验科

出　　处：《青岛大学学报（医学版）》2022年第1期131-135,共5页Journal of Qingdao University(Medical Sciences)

基　　金：山东省医药卫生科技发展计划项目(2016WS02-58)。

摘　　要：目的了解泌尿外科住院病人血培养病原菌分布及其对抗生素的敏感情况,为临床合理应用抗生素提供科学依据。方法收集2014年1月—2019年12月青岛大学附属医院泌尿外科送检的846份标本血培养结果,对病原菌阳性率、分布及药物敏感试验结果进行回顾性分析。结果846份标本共分离出病原菌120株,检出率14.2%。其中革兰阴性菌、革兰阳性菌、真菌分别检出89(74.2%)、25(20.8%)、6(5.0%)例,革兰阴性菌中大肠埃希菌占比最高,粪肠球菌和表皮葡萄球菌为革兰阳性菌中最常见菌种;产超广谱β-内酰胺酶革兰阴性菌检出率较高。大肠埃希菌对临床上常用的第一、二、三代头孢菌素及喹诺酮类抗生素敏感性均较低,铜绿假单胞菌出现耐亚胺培南菌株,粪肠球菌、葡萄球菌对利奈唑胺、替加环素、替考拉宁和万古霉素非常敏感。结论泌尿外科血流感染病原菌以革兰阴性菌为主,大肠埃希菌为主要致病菌,产超广谱β-内酰胺酶检出率较高,致病菌对常用抗生素耐药严重。Objective To investigate the distribution and sensitivity to antibiotics of pathogens in blood culture of inpatients in Department of Urology in The Affiliated Hospital of Qingdao University,and to provide a scientific reference for rational clinical application of antibiotics.Methods The blood culture results of 846 samples from Department of Urology,The Affiliated Hospital of Qingdao University,from January 2014 to December 2019 were collected,and a retrospective analysis was performed on the positive rate,distribution,and drug sensitivity test results of pathogens.Results A total of 120 strains of pathogens were isolated from the 846 samples,with a detection rate of 14.2%,among which 89 strains(74.2%)were Gram-negative bacteria,25 strains(20.8%)were Gram-positive bacteria,and 6 strains(5.0%)were fungi.Escherichia coli had the highest proportion in Gram-negative bacteria.Enterococcus faecalis and Staphylococcus epidermidis were the most common species in Gram-positive bacteria.Extended-spectrum beta-lactamases-producing Gram-negative bacteria had a high detection rate.Escherichia coli was less sensitive to the first-,second-,and third-generation cephalosporins and quinolones commonly used in clinical therapy.Pseudomonas aeruginosa developed imipenem resistance.Enterococcus faecalis and staphylococci were very sensitive to linezolid,tigecycline,teicoplanin,and vancomycin.Conclusion The main cause of urological bloodstream infection is Gram-negative bacteria,and E.coli is the main pathogen.Extended-spectrum beta-lactamases-producing Gram-negative bacteria have a high detection rate.The pathogens have strong resistance to commonly used antibiotics.

关 键 词：泌尿科 医院 血培养 微生物敏感性试验 抗药性 细菌 

分 类 号：R446.5[医药卫生—诊断学]