某院血培养阳性的常见病原菌分布特点及耐药性分析  

Distribution and Drug Resistance Analysis of Blood Culture Pathogens in a Hospital in the Past 6 Years

作　　者：彭纳 陈小娟 Peng Na;Chen Xiaojuan(Department of Clinical Laboratory,Hui Ya Hospital of The First Affiliated Hospital,Sun Yat-Sen University,Huizhou,Guangdong,516081,China)

机构地区：[1]惠州市中大惠亚医院检验科,广东惠州516081

出　　处：《黑龙江医学》2024年第17期2104-2107,2111,共5页Heilongjiang Medical Journal

摘　　要：目的:分析某院血培养阳性病原菌分布特点及体外药敏实验结果,为临床提供合理使用抗菌药物的依据。方法:回顾性分析2017年1月—2022年12月惠州市中大惠亚医院门诊及住院送检的血培养阳性样本数据,采用WHONET 5.6软件对血培养分离到的病原菌的分布情况及药敏结果进行统计分析。结果:2017年1月—2019年12月总共分离非重复菌株207例,2020年1月—2022年12月总共分离非重复菌株285例,以革兰阴性菌为主,其次是革兰阳性菌,真菌检出少。血流感染中的大肠埃希菌的检出率升高,产超广谱β-内酰胺酶(ESBLs)检出率则有所下降,未检出碳青霉烯耐药的大肠埃希菌。阿米卡星、头孢哌酮/舒巴坦对肺炎克雷伯菌保持较高的抗菌活性。葡萄球菌对青霉素高度耐药,未发现对万古霉素、利奈唑胺和替加环素耐药的菌株。肠球菌和非发酵菌株的检出率比较低。结论:医院血培养阳性分离的细菌以革兰阴性菌为主,大肠埃希菌是血流感染的最主要的致病菌。同时,不同的病原菌对抗菌药物的耐药性存在较大的差异,对于不明原因的发热或疑似血流感染的患者应在抗菌药物使用之前及时进行血培养的送检,对临床诊治血流感染及合理选用抗菌药物至关重要。Objective:To analyze the distribution and drug resistance of pathogenic bacteria in blood culture samples of patients with blood flow infection,in order to provide clinical rational drug use and treatment plan.Methods:Retrospectively analyzing the isolated strains of positive specimens from the blood culture in the Hui Ya Hospital of The First Affiliated Hospital,Sun Yat-Sen University from January 2017 to December 2022.Results:A total of 207 non repetitive strains were isolated from January 2017 to December 2019,and a total of 285 non repetitive strains were isolated from January 2020 to December 2022.The gram-negative bacteria were dominant,followed by gram-positive bacteria and fungi.The detection rates of Escherichia coli in bloodstream infections have increased,however,the detection rates of ESBLs in Escherichia coli were on the decline.No carbapenem resistant Escherichia coli was detected.Amikacin,cefoperazone/sulbactam maintained high antibacterial activity against Klebsiella pneumoniae.Staphylococcus was highly resistant to penicillin,and no strains resistant to vancomycin,linezolid and tigecycline were found.The detection rate of Enterococcus and non fermenting strains was low.Conclusion:The bacteria isolated from positive blood culture in this hospital are mainly Gram negative bacteria,and Escherichia coli is the most common pathogenic bacteria for bloodstream infections.Different pathogens have great differences in drug resistance.Patients with unexplained fever or suspected bloodstream infection should have timely and standardized submission of blood culture before antibiotic use.It’s important for clinical diagnosis and treatment of bloodstream infections and the rational use of antibiotics.

关 键 词：血培养 血流感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]