住院病人血培养病原菌种类及药敏结果分析  

Analysis of pathogenic bacteria types and drug sensitivity results in blood culture of hospitalized patients

作　　者：刘宝[1] 孙淼[1] 张克昌[2] LIU Bao(Medical College of Chuzhou City Vocational College,Chuzhou,Anhui 239000,China)

机构地区：[1]滁州城市职业学院医学院,安徽滁州239000 [2]滁州市第一人民医院检验科,安徽滁州239000

出　　处：《牡丹江医学院学报》2023年第4期92-96,共5页Journal of Mudanjiang Medical University

基　　金：安徽省高校学科(专业)拔尖人才学术资助项目(gxbjZD2021118);安徽省质量工程项目(2021jyxm1043);滁州城市职业院级质量工程重点项目(2020jyxm04);滁州城市职业学院自然科学研究重点项目(2021zk04);滁州城市职业学院人文社会科研重点项目(2021sk09)。

摘　　要：目的监测血流感染病原菌在各科室及不同患者年龄段分布以及分析其耐药性,为临床选择敏感药物提供依据。方法回顾性观察2019年9月至2022年5月间在滁州市第一人民医院的住院病人全血培养结果(排除操作污染),对血培养阳性标本的病人年龄、就诊科室、主要病原菌的分布及耐药情况进行统计分析。结果血培养分离病原菌在60岁以上老年人标本中比率最高,20岁以下年龄段比率最低,分别占11.38%和3.37%;革兰氏阳性菌株数与革兰氏阴性菌株数无统计学差异;在革兰氏阳性菌中,金黄色葡萄球菌及溶血性葡萄球菌所占的比率最大,分别占总菌株10.14%、17.39%;革兰氏阴性菌中,大肠埃希菌及肺炎克雷伯菌所占的比率最高,分别占总菌株24.64%、15.46%;四种主要病原菌在医院内大多科室都有分布,但分布不均;金黄色葡萄球菌和溶血性葡萄球菌对达托霉素、利奈唑胺及万古霉素都敏感;大肠埃希菌对阿米卡星、阿莫西林/克拉维酸钾、厄他培南、亚胺培南、美罗培南、哌拉西林/他唑巴坦及加替沙星都敏感;肺炎克雷伯菌除对阿米卡星、阿莫西林/克拉维酸钾、四环素、加替沙星及妥布霉素有一定的敏感外,对其它抗菌药物都存在一定的耐药率。结论医院血流感染病原菌在各年龄段及临床科室分布不同,无论革兰氏阳性球菌或肠杆菌科细菌对常用药物都存在较高的耐药性,临床医师应根据药物监测结果选择用药。Objective Monitor the distribution of blood flow infection pathogenic bacteria in various departments and age groups of patients,and analyze drug resistance,providing a basis for the clinical selection of sensitive drugs.Methods The whole blood culture results of inpatients in Chuzhou First People’s Hospital from September 2019 to May 2022(excluding operation pollution)were retrospectively observed,and the age of patients with positive blood culture samples,medical departments,distribution of main pathogens and drug resistance were statistically analyzed.Results The proportion of pathogenic bacteria isolated from blood culture was the highest among specimens of elderly people over 60 years old,and the lowest among those under 20 years old,accounting for 11.38%and 3.37%respectively;There is no significant difference in the number of Gram positive and Gram negative bacteria.Among Gram positive bacteria,Staphylococcus aureus and Staphylococcus hemolyticus account for the largest proportion,accounting for 10.14%and 17.39%of the total strains,respectively;Among Gram negative bacteria,Escherichia coli and Klebsiella pneumoniae account for the highest proportion,accounting for 24.64%and 15.46%of the total strains,respectively;The four main pathogenic bacteria are distributed in most departments of hospitals,but their distribution is uneven;Staphylococcus aureus and Staphylococcus hemolyticus were sensitive to daptomycin,linezolid and vancomycin;Escherichia coli is sensitive to amikacin,amoxicillin/clavulanic acid potassium,ertapenem,imipenem,meropenem,piperacillin/tazobactam and gatifloxacin;Klebsiella pneumoniae is sensitive to amikacin,amoxicillin/clavulanic acid potassium,tetracycline,gatifloxacin and tobramycin,and has certain resistance to other antibiotics.Conclusion The distribution of pathogenic bacteria of hospital blood flow infection is different in different age groups and clinical departments.Both Gram positive cocci and Enterobacteriaceae bacteria have high resistance to commonly used drugs.Clinicians sh

关 键 词：血流感染 血培养 主要病原菌 耐药 选择用药 

分 类 号：R446.5[医药卫生—诊断学]