广西壮族自治区耐药监测网三级医院2015—2021年血标本病原菌分布及耐药分析  

Analysis of distribution and drug resistance of pathogens in bloodstream infections in Guangxi antibiotics resistance monitoring network from 2015 to 2021

作　　者：赵丽[1] 胡柳杨 刘晓春 陈杏春[1] 黄莎圆子 徐莹莹 梁亮[1] 农生州 Zhao Li;Hu Liu-yang;Liu Xiao-chun;Chen Xing-chun;Huang Sha-yuan-zi;Xu Ying-ying;Liang Liang;Nong Sheng-zhou(Depatment of Clinical Laboratory,Guangxi Zhuang Autonomous Region Peoples Hospital,Nanning 530021;Guangxi Center of Clinical Laboratory,Nanning 530021)

机构地区：[1]广西壮族自治区人民医院检验科,南宁530021 [2]广西壮族自治区临床检验中心,南宁530021

出　　处：《中国抗生素杂志》2023年第5期586-594,共9页Chinese Journal of Antibiotics

基　　金：广西医药卫生科研课题(No.Z2015329和No.Z20170320)。

摘　　要：目的监测广西壮族自治区三级医院2015—2021年血标本病原菌的分布及耐药性,为临床血流感染诊断和治疗提供可靠的依据。方法对广西壮族自治区细菌耐药检测网三级医院2015—2021年临床血标本中分离的非重复病原菌进行统计分析。结果2015—2021年从血标本中分离出病原细菌96326株,其中革兰阴性菌57672株(59.87%),革兰阳性菌38654株(40.13%)。检出率排名前10位的分别为大肠埃希菌27871株(28.93%)、凝固酶阴性葡萄球菌20624株(21.41%)、肺炎克雷伯菌11685株(12.13%)、金黄色葡萄球菌8798株(9.13%)、铜绿假单胞菌3547株(3.68%)、鲍曼不动杆菌2908株(3.02%)、沙门菌属1901株(1.97%)、粪肠球菌1707株(1.77%)、阴沟肠杆菌1655株(1.72%)和屎肠球菌1533株(1.59%)。大肠埃希菌、肺炎克雷伯菌对碳青霉烯类药物的耐药率分别为1.1%和3.4%。耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为27.8%和76.9%,未发现万古霉素耐药的葡萄球菌。肠球菌属中以粪肠球菌1707/3663(46.6%)和屎肠球菌1533/3663(41.8%)为主,粪肠球菌、屎肠球菌对利奈唑胺、万古霉素的耐药率分别为2.1%、0.4%和0.7%、0.9%。链球菌属前3位分别为肺炎链球菌1216/4795(25.4%)、无乳链球菌677/4795(14.1%)和缓症链球菌569/4795(11.9%)。青霉素耐药肺炎链球菌检出率为1.5%,未检出对万古霉素耐药的链球菌。布鲁菌共检出71株。结论广西壮族自治区血标本的病原菌有区域特征性,7年间病原菌的构成及耐药率有一定的变化。加强本地区血标本病原菌的分布及耐药性的监测,及时分布权威数据,对于有效的临床治疗和感染控制非常重要。Objective The distribution and drug resistance of pathogens of bloodstream infections in Guangxi Zhuang Autonomous region from 2015 to 2021 were analyzed to provide a reliable basis for clinical diagnosis and treatment of bloodstream infections.Methods Non-repeating pathogens isolated from clinical blood samples of Grade Three A Hospitals in the bacterial drug resistance monitoring network from 2015 to 2021.Results From 2015 to 2021,96,326 strains of pathogenic bacteria were isolated from blood samples,including 57,672 strains(59.87%)of Gram-negative bacteria and 38,654 strains(40.13%)of Gram-positive bacteria.The top 10 detection rates were 27,871 strains of Escherichia coli(28.93%),20,624 strains of coagulase negative Staphylococcus(21.41%),11,685 strains of Klebsiella pneumoniae(12.13%),8,798 strains of Staphylococcus aureus(9.13%),3,547 strains of Pseudomonas aeruginosa(3.68%),2,908 strains of Acinetobacter baumannii(3.02%),1,901 strains of Salmonella(1.97%),1,707 strains of Enterococcus faecalis(1.77%),1,655 strains of Enterobacter cloacae(1.72%),and 1,533 strains of Enterococcus faecium(1.59%).The resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenem were 1.1%and 3.4%respectively.The detection rates of methicillin-resistant strains in Staphylococcus aureus(MRSA)and coagulase-negative staphylococci(MRCNS)were 27.8%and 76.9%respectively.No strains were resistant to vancomycin.Enterococci were mainly Enterococcus faecalis(1,707/3,663,46.6%)and Enterococcus faecium(1,533/3,663,41.9%),and their resistance rates to linezolid and vancomycin were 2.1%,0.4%(Enterococcus faecalis)and 0.7%,0.9%(Enterococcus faecium),respectively.The top three streptococci were Streptococcus pneumoniae(1,216/4,795,25.4%),Streptococcus agalactiae(677/4,795,14.1%),and Streptococcus mitis(569/4,795,11.9%).The resistance rate of Streptococcus pneumoniae to penicillin was 1.5%,and no vancomycin resistant Streptococcus was detected.71 strains of brucella were detected.Conclusion The pathogenic bacteria in blood samples

关 键 词：广西壮族自治区 血流感染 病原菌 耐药分析 

分 类 号：R978.1[医药卫生—药品]