2015—2020年晋东南地区某医院血培养病原菌 分布及耐药性分析  

Distribution and Drug Resistance of Bacteria Isolated from Blood Culture of a Hospital in Southeast Shanxi from 2015 to 2020

作　　者：白杨[1] 弓艳娥[1] 李晖[1] 申芳芳[1] 程燕[1] 纪爱芳[1] 禹淑艳 BAI Yang;GONG Yane;LI Hui;SHEN Fangfang;CHENG Yan;JI Aifang;YU Shuyan(Department of Clinical Laboratory,Heping Hospital Affiliated to Changzhi Medical College)

机构地区：[1]长治医学院附属和平医院检验科,046000 [2]承德第六人民医院检验科

出　　处：《长治医学院学报》2022年第4期264-270,共7页Journal of Changzhi Medical College

基　　金：长治医学院附属和平医院2019年度院级科研基金(HPYJ201911)。

摘　　要：目的:分析晋东南地区某医院血培养阳性病原菌分布及其耐药性,为院感监测、抗菌药物的合理使用及防控血流感染提供依据。方法:收集2015—2020年血培养分离的病原菌数据,依据CSLI药敏试验执行标准,运用WHONET 5.6软件对药敏结果进行分析。结果:42110份血培养标本共检出病原菌4173株,阳性率维持在10%左右,去重后共有病原菌1842株;其中革兰氏阳性菌43.8%,革兰氏阴性菌54.6%,真菌1.1%,厌氧菌0.5%;菌株分布排名前5位分别是大肠埃希菌30.2%、凝固酶阴性葡萄球菌(CNS)25.6%、肺炎克雷伯菌9.4%、金黄色葡萄球菌5.6%、链球菌属5.1%;甲氧西林耐药的金黄色葡萄球菌(MRSA)检出率为28.8%,甲氧西林耐药的凝固酶阴性葡萄球菌(MRCNS)的检出率为75.6%;所有葡萄球菌对利奈唑胺和万古霉素敏感;以大肠埃希菌为代表的肠杆菌科细菌占67.1%,其对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢他啶、氨曲南、亚胺培南和阿米卡星的耐药率较低;对碳青霉烯类耐药的肠杆菌科细菌(CRE)总检出率为0.8%,对碳青霉烯类耐药的铜绿假单胞菌(CRPA)和鲍曼不动杆菌(CRAB)检出率分别为5.4%和64.3%。结论:近6年血培养标本送检量整体逐年升高,但标本阳性率6年来维持在全国中下游水平且变化不大;菌种分布及菌株耐药率整体上与全国水平较为一致,但也有区域性特点;需要加强与临床、药剂科的沟通,促进抗菌药物合理使用,共同延缓、控制多药耐药菌在本地区的产生和传播。Objective:To analyze the distribution and drug resistance of pathogenic bacteria strains isolated from blood culture in a hospital in southeast Shanxi,and to provide evidence for monitoring hospital infection,rational use of antibacterial drugs,and prevention and control of bloodstream infections.Methods:The data of pathogenic bacteria isolated by blood culture was collected from 2015 to 2020.The antimicrobial susceptibility test was carried out according to CSLI 2020 and analyzed by WHONET 5.6 software.Results:A total of 4173 pathogens were isolated from 42110 blood culture samples,and the positive rate was maintained at about 10%.After deduplication,a total of 1842 isolates were left,of which 43.8%of gram-positive bacteria,54.6%of gram-negative bacteria,1.1%of fungi,and 0.5%of anaerobes.The top 5 strains were Escherichia coli 30.2%,Coagulase-negative Staphylococcus(CNS)25.6%,Klebsiella pneumoniae 9.4%,Staphylococcus aureus 5.6%,and Streptococcus 5.1%.The detection rate of methicillin-resistant S.aureus(MRSA)was 28.8%,and the detection rate of methicillin-resistant coagulase-negative Staphylococcus(MRCNS)was 75.6%;all staphylococci were sensitive to linezolid and vancomycin.Enterobacteriaceae,represented by E.coli,accounted for 67.1%and had a lower resistance rate to cefoperazone/sulbactam,piperacillin/tazobactam,ceftazidime,aztreonam,imipenem,and amikacin;the total detection rate of Carbapenem-resistant Enterobacteriaceae(CRE)was 0.84%.The detection rates of Carbapenem-resistant Pseudomonas aeruginosa(CRPA)and Acinetobacter baumannii(CRAB)were 5.4%and 64.3%,respectively.Conclusion:The amount of blood culture specimens sent for testing in the hospital in the past 6 years has increased year by year,but the positive rate of blood culture has remained in the middle or lower reaches of the country for 6 years with little change;the distribution and antimicrobial resistance of pathogenic bacteria strains isolated from blood culture are generally consistent with the national level,but it still showed regional characte

关 键 词：血流感染 血培养 病原菌 细菌耐药性监测 

分 类 号：R446.5[医药卫生—诊断学]