2019—2021年广西玉林地区住院患者血流感染病原菌分布及耐药性分析  

Distribution and drug resistance analysis of pathogenic bacteria of blood flow infection in hospitalized patients in Yulin,Guangxi from 2019 to 2021

作　　者：丘丹萍 李泰阶 林青 薛野 覃美香 李艳玲 李倩 QIU Dan-ping;LI Tai-jie;LIN Qing;XUE Ye;QIN Mei-xiang;LI Yan-ling;LI Qian(Department of Laboratory Medicine,Yulin First People's Hospital,Yulin 537035,Guangxi,CHINA;Department of Laboratory Medicine,Wuming Hospital of Guangxi Medical University,Nanning 530199,Guangxi,CHINA)

机构地区：[1]玉林市第一人民医院检验科,广西玉林537035 [2]广西医科大学附属武鸣医院医学检验科,广西南宁530199

出　　处：《海南医学》2023年第10期1466-1470,共5页Hainan Medical Journal

基　　金：广西壮族自治区中医药管理局自筹经费科研课题(编号:GZZC2020208);广西高校中青年教师科研基础能力提升项目(编号:2021KY0121);广西南宁市武鸣区科学研究与技术开发计划项目(编号:20200216);广西玉林市科学研究与技术开发计划项目(编号:玉市科20204303)。

摘　　要：目的 分析2019年1月至2021年12月玉林地区住院患者血流感染病原菌的分布及耐药性,为本地区临床医生合理使用抗菌药物提供科学依据。方法 回顾性分析2019年1月至2021年12月在玉林市第一人民医院就诊的住院患者送检血培养阳性的资料,对其病原菌分布及抗菌药物敏感性进行分析。结果 2019年1月至2021年12月共分离病原菌3 946株,其中革兰阴性菌2 618株(66.3%),革兰阳性菌1 069株(27.1%),真菌259株(6.6%)。病原菌主要分布在ICU病房(650株,16.5%),其次是感染性疾病科(281株,7.1%)。血培养阳性分离株排前6位的菌株分别为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、鲍曼不动杆菌、铜绿假单胞菌和白念珠菌。大肠埃希菌对碳青霉烯类的耐药率低于1.0%,肺炎克雷伯菌对碳青霉烯类的耐药率从3.3%上升到10.5%,而鲍曼不动杆菌对碳青霉烯类的耐药率呈下降趋势且未发现对替加环素耐药。葡萄球菌和粪肠球菌对万古霉素、利奈唑胺和替加环素的敏感率为100%。白念珠菌对氟康唑和伏立康唑保持较高的敏感性,热带念珠菌对氟康唑和伏立康唑耐药率较高,为23.3%。结论 玉林地区住院患者血流感染病原菌以革兰阴性杆菌为主,真菌的检出率呈上升趋势,肺炎克雷伯菌对碳青霉烯类的耐药率上升较为明显。动态监测血培养病原菌的构成变化及耐药率变迁,为临床合理使用抗菌药物提供科学依据。Objective To analyze the distribution and drug resistance of pathogenic bacteria of bloodstream in-fection in hospitalized patients in Yulin from January 2019 to December 2021,so as to provide scientific basis for the ratio-nal use of antibiotics by clinicians in the region.Methods Retrospective analysis was made on the data of positive blood culture of inpatients in Yulin First People's Hospital from January 2019 to December 2021,and the distribution of patho-genic bacteria and antimicrobial susceptibility were analyzed.Results From January 2019 to December 2021,3946 strains of pathogenic bacteria were isolated,including 2618 strains of Gram-negative bacteria(66.3%),1069 strains of Gram-positive bacteria(27.1%),and 259 strains of fungi(6.6%).The pathogens were mainly distributed in ICU wards(650 strains,16.5%),followed by infectious diseases(281 strains,7.1%).The top 6 strains of blood culture positive iso-lates were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Acinetobacter baumannii,Pseudomonas aerugino-sa,and Candida albicans.The resistance rate of Escherichia coli to carbapenems was lower than 1.0%,and that of Klebsiella pneumoniae to carbapenems increased from 3.3%to 10.5%.Acinetobacter baumannii showed a downward resistance to car-bapenems and no resistance to tegacyclin.The sensitivity rate of Staphylococcus aureus and Enterococcus faecalis to vanco-mycin,linezolid,and tegacyclin was 100%.Candida albicans maintained a high sensitivity to fluconazole and voricon-azole,and the resistance rate of Candida tropicalis to fluconazole and voriconazole was 23.3%.Conclusion Gram-nega-tive bacilli are the main pathogens of bloodstream infection in inpatients in Yulin area.The detection rate of fungi is in-creasing.The drug resistance rate of Klebsiella pneumoniae to carbapenems is increasing significantly.Dynamic monitor-ing of the changes in the composition and drug resistance rate of pathogenic bacteria in blood culture provides scientific basis for the rational use of antibiotics in clinical pract

关 键 词：玉林地区 血培养 血流感染 病原菌 耐药性 

分 类 号：R446.11[医药卫生—诊断学]