某三甲医院2019年常见血源性感染病原菌分布及耐药性分析  

Distribution and drug resistance analysis of blood-borne pathogens in a grade 3 class A hospital in 2019

作　　者：王梅 高建敏 李彩珠 林振山 王小智[1] WANG Mei;GAO Jian-min;LI Cai-zhu;LIN Zhen-shan;WANG Xiao-zhi(Department of Critical Care Medicine,the Second Affiliated Hospital of Hainan Medical College,Haikou 570216,Hainan,CHINA;Intensive Care Unit,Shenshan Medical Center,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Shanwei 516600,Guangdong,CHINA;Department of Nuclear Medicine,Shenshan Medical Center,Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Shanwei 516600,Guangdong,CHINA)

机构地区：[1]海南医学院第二附属医院重症医学科,海南海口570216 [2]中山大学孙逸仙纪念医院深汕中心医院重症医学科,广东汕尾516600 [3]中山大学孙逸仙纪念医院深汕中心医院核医学科,广东汕尾516600

出　　处：《海南医学》2022年第22期2929-2932,共4页Hainan Medical Journal

基　　金：2020年海南医学院校级科研创新基金项目(编号:HYYS2020-39)。

摘　　要：目的了解我院2019年住院患者血源性感染细菌构成和对抗菌药物的耐药性。方法收集2019年1~12月海南医学院第二附属医院临床分离的503株血源性感染的非重复病原菌。使用珠海美华自动菌液接种及鉴定药敏分析系统MA120进行药敏分析,药敏结果判断根据美国临床实验室标准化协会(CLSI)指南M1002019版标准,采用WHONET 5.6软件对本院分离细菌耐药性进行统计分析。结果分离非重复菌503株,其中革兰阴性菌332株,占66.0%,革兰阳性菌140株,占27.8%,分离真菌31株,占6.2%;检出菌排在前四位的病原菌分别是大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为75.0%和20.5%,未发现耐利奈唑胺和万古霉素的葡萄球菌;产超广谱β内酰胺酶(ESBLs)的大肠埃希菌、肺炎克雷伯菌杆菌分别为各自菌的29.5%和21.5%;大三代头孢类抗菌药物在大肠埃希菌、肺炎克雷伯菌中耐药率较高;鲍曼不动杆菌、铜绿假单胞菌和肺炎克雷伯菌对碳青霉烯类耐药率分别为27.3%、16.0%和5.0%;大肠杆菌对碳青霉烯类高度敏感,对氨苄西林耐药率达78.0%。结论我院2019年住院患者血源性分离菌以革兰阴性菌为主,其中以大肠埃希菌为首,碳青霉烯类抗菌药物对肠杆菌科细菌耐药率低。Objective To assesses the distribution and drug resistance of blood-borne pathogens in a grade 3 class A hospital in 2019.Methods A total of 503 strains of different blood-borne pathogens were collected from the Second Affiliated Hospital of Hainan Medical College from January to December 2019.Drug sensitivity analysis was performed using automatic bacteria incubators(Zhuhai Meihua)and identification drug sensitivity analysis system MA120.Sensitivity results were determined according to the Clinical and Laboratory Standard Institute(CLSI)Guidelines M1002019 standard and analyzed by software WHONET5.6.Results A total of 503 different strains were isolated in 2019,including 332(66.0%)strains of Gram-negative and 140(27.8%)of Gram-positive bacteria,and 31(6.2%)of fungus.Escherichia coli were detected most frequently,followed by Klebsiella pneumonia,Staphylococcus aureus,Pseudomonas aeruginosa.The prevalence of methicillin-resistant strains was 75.0%in coagulase-negative Staphylococcus(MRCNS)and 20.5%in S.aureus(MRSA).However,there were no evidences indicated vancomycin-and linezolid-resistant Staphylococcus.The incidences of extended-spectrumβ-lactamases(ESBLs)in Escherichia coli and Klebsiella pneumonia were 29.5%and 21.5%.Escherichia coli and Klebsiella pneumonia isolates were highly resistant to third-generation cephalosporins.The resistance rate to carbapenems was 27.3%in Acinetobacter baumannii,16.0%in Pseudomonas aeruginosa,5.0%in Klebsiella pneumonia.However,Escherichia coli was highly sensitive to carbapenems,but the resistance rate of Escherichia coli to ampicillin was 78.0%.Conclusion Gram-negative strains were the most frequently detected pathogens in blood cultures in the hospital in 2019,mainly Escherichia coli.Enterobacteriaceae bacteria had low resistance rate to carbapenems.

关 键 词：海南 三甲医院 血培养 革兰阴性菌 革兰阳性菌 抗菌药物 耐药性 

分 类 号：R37[医药卫生—病原生物学]