2019至2021年某三甲医院血培养分离菌分布及耐药性分析  

Distribution and drug resistance analysis of bacteria isolated from blood culture in a tertiary hospital from 2019 to 2021

作　　者：孙倩[1] 范士英[1] 李继红[1] 赵建宏[1] 张琳[1] 时东彦[1] SUN Qian;FAN Shiying;LI Jihong(Department of Laboratory Medicine,the Second Hospital of Hebei Medical University,Hebei,Shijiazhuang 050000,China)

机构地区：[1]河北医科大学第二医院检验科,石家庄市050000

出　　处：《河北医药》2023年第20期3175-3180,共6页Hebei Medical Journal

摘　　要：目的分析河北医科大学第二医院近3年血培养分离菌的分布及耐药特征,为临床抗菌药物的合理应用提供依据。方法回顾性对河北医科大学第二医院2019年1月至2021年12月血培养分离菌分布及耐药性进行分析。结果共分离出细菌真菌菌株2520株,其中革兰阴性菌1429株(56.7%),革兰阳性菌970株(38.5%),真菌121株(4.8%)。革兰阴性菌中前三位的分离菌分别为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌,革兰阳性菌中前三位的分离菌分别是人葡萄球菌、表皮葡萄球菌、屎肠球菌,真菌前三位分离菌是白念珠菌、光滑念珠菌、热带念珠菌。血培养分离菌检出前五位的科室分别为重症医学科、血液科、呼吸科、消化科、感染科。肺炎克雷伯菌对亚胺培南和美罗培南的耐药率分别是43.5%和43.2%,大肠埃希菌对亚胺培南和美罗培南的耐药率分别是3.6%和3.3%。葡萄球菌中,耐甲氧西林金黄色葡萄球菌(MRSA)及耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别是36.6%和89.4%。结论河北医科大学第二医院血培养分离菌以革兰阴性菌为主,各分离菌对抗菌药物耐药性存在较大差异,对血培养分离菌的分布及耐药情况及时准确地进行监测报告,对临床合理选择抗菌药敏具有重要指导意义。Objective To analyze the distribution and drug resistance characteristics of bacteria isolated from blood culture in the Second Hospital of Hebei Medical University within the past three years,thus providing a basis for the rational application of clinical antibiotics.Methods The distribution and drug resistance of pathogenic bacteria from blood culture between January 2019 and December 2021 in the Second Hospital of Hebei Medical University were retrospectively analyzed.Results A total of 2520 bacterial and fungal strains were isolated,including 1,429 gram-negative bacteria(56.7%),970 gram-positive bacteria(38.5%),and 121 fungi(4.8%).The top three pathogens among gram-negative bacteria were Klebsiella pneumoniae,Escherichia coli,and Pseudomonas aeruginosa,and the top three pathogens among gram-positive bacteria were Staphylococcus hominis,Staphylococcus epidermidis,and Enterococcus faecium.The top three fungi were Candida albicans,Candida glabrata,and Candida tropicalis.The top five departments for the detection of pathogenic bacteria were the Department of Critical Care Medicine,the Department of Hematology,the Department of Respiratory Medicine,the Department of Gastroenterology,and the Department of Infectious Diseases.The resistance rate of Klebsiella pneumoniae to imipenem and meropenem was 43.5%and 43.2%,respectively,and the resistance rate of Escherichia coli to imipenem and meropenem was 3.6%and 3.3%,respectively.Among Staphylococcus,the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative staphylococci(MRCNS)strains was 36.6%and 89.4%,respectively.Conclusion The blood culture isolates from the Second Hospital of Hebei Medical University are mainly gram-negative bacteria,and the resistance of each isolate to antibiotics differs a lot.It has an important guiding significance for the rational selection of antimicrobial susceptibility in clinical practice based on timely and accurate monitoring reports on the distribution and drug resistance charact

关 键 词：血培养 分离菌 耐药性 

分 类 号：R372[医药卫生—病原生物学]