某院近10 年血流感染病原菌分布及耐药趋势分析  

Distribution and Drug Resistance Trend of Pathogenic Bacteria Inducing BloodstreamInfection in a Hospital in Recent Ten Years

作　　者：郑巧伟[1] 罗赛赛 任晓东[1] 陈延绅 张迪[1] 封卫毅[1] 魏友霞[1] ZHENG Qiaowei;LUO Saisai;REN Xiaodong;CHEN Yanshen;ZHANG Di;FENG Weiyi;WEI Youxia(Department of Pharmacology,The First Affiliated Hospital of Xi′an Jiaotong University,Xi′an,Shaanxi,China 710061)

机构地区：[1]西安交通大学第一附属医院药学部,陕西西安710061

出　　处：《中国药业》2022年第11期116-120,共5页China Pharmaceuticals

基　　金：陕西省自然科学基础研究计划项目[2018JM7053];西安交通大学第一附属医院基金项目[2016MS-06]。

摘　　要：目的探讨某院血流感染常见病原菌的分布及耐药趋势。方法收集医院2009年至2019年收治的血流感染患者的非重复病原菌,采用全自动微生物分析仪鉴定细菌,采用Kirby-Bauer(K-B)法及自动化仪器进行药物敏感性(简称药敏)试验,采用WHONET 5.6软件分析药敏试验结果,其余数据采用SPSS 24.0统计学软件分析。结果共分离到病原菌7628株,其中革兰阴性菌4472株(58.63%),革兰阳性菌2929株(38.40%),真菌227株(2.98%)。大肠埃希菌是血流感染的最主要致病菌(28.72%)。大肠埃希菌和铜绿假单胞菌主要分布在第3季度,肺炎克雷伯菌第3季度和第4季度分离数量较多,表皮葡萄球菌第4季度分离数量最多。革兰阴性菌中,大肠埃希菌对阿米卡星、庆大霉素、左氧氟沙星的耐药率均呈总体下降趋势;肺炎克雷伯菌对头孢他啶和头孢吡肟的耐药率均呈总体下降趋势,对阿米卡星和头孢哌酮舒巴坦的耐药率均呈总体上升趋势;铜绿假单胞菌对环丙沙星、亚胺培南、左氧氟沙星的耐药率均呈总体下降趋势。共检出混合血流感染患者702例,主要合并感染大肠埃希菌(39.46%)、肺炎克雷伯菌(24.79%)、屎肠球菌(23.93%)等病原菌,其中合并2种病原菌的检出率为84.90%。多重耐药菌中,耐碳青霉烯类肺炎克雷伯菌的检出率呈总体上升趋势,其他多重耐药菌的检出率均存在波动性。结论临床应加强血流感染病原菌的耐药监测,合理使用抗菌药物。Objective To investigate the distribution and drug resistance trend of common pathogenic bacteria inducing bloodstream infection in a hospital.Methods Non-repeated pathogenic bacteria were collected from patients with bloodstream infection admitted to the hospital from 2009 to 2019.The automatic microorganism analyzer was used to identify bacteria.The Kirby-Bauer(K-B)method and automated instrument were used to conduct the antimicrobial susceptibility test.The WHONET 5.6 software was used to analyze the results of antimicrobial susceptibility test.The SPSS 24.0 statistical software was used to analyze the other data.Results A total of 7628 strains of pathogenic bacteria were isolated,including 4472 strains of gram-negative bacteria(58.63%),2929 strains of gram-positive bacteria(38.40%)and 227 strains of fungi(2.98%).Escherichia coli was the main pathogenic bacteria inducing bloodstream infection(28.72%).Escherichia coli and Pseudomonas aeruginosa were mainly distributed in the third quarter,Klebsiella pneumoniae was mainly isolated in the third and fourth quarters,and Staphylococcus epidermidis was mainly isolated in the fourth quarter.Among the gram-negative bacteria,the resistance rates of Escherichia coli to amikacin,gentamicin and levofloxacin showed overall downward trends,the resistance rates of Klebsiella pneumoniae to ceftazidime and cefepime showed overall downward trends,while the resistance rates of Klebsiella pneumoniae to amikacin,cefoperazone and sulbactam showed overall upward trends,and the resistance rates of Pseudomonas aeruginosa to ciprofloxacin,imipenem and levofloxacin showed overall downward trends.A total of 702 patients with mixed bloodstream infection were detected,mainly co-infected with pathogenic bacteria such as Escherichia coli(39.46%),Klebsiella pneumoniae(24.79%)and Enterococcus faecium(23.93%),and the detection rate of patients co-infected with two kinds of pathogenic bacteria was 84.90%.Among the multi-drug resistant organisms(MDROs),the detection rate of carbapenem-resistant Kl

关 键 词：血流感染 革兰阳性菌 革兰阴性菌 多重耐药菌 耐药趋势 

分 类 号：R95[医药卫生—药学]