2017年—2022年某院住院患者血流感染病原菌分布及耐药分析  

Distribution and Drug Resistance Analysisof Pathogenic Bacteria in Blood Stream Infectionof Hospitalized Patients in a Hospital from 2017 to 2022

作　　者：李晓华[1] 付裕[1] 曹贤[1] 张艳玲[1] 张娜[1] Li Xiao-hua;Fu Yu;Cao Xian;Zhang Yan-ling;Zhang Na(Ordos Central Hospital,Ordos Inner Mongolia 017000)

机构地区：[1]鄂尔多斯市中心医院,内蒙古鄂尔多斯017000

出　　处：《国外医药（抗生素分册）》2024年第5期312-318,共7页World Notes on Antibiotics

基　　金：内蒙古自治区科技计划“十四五”社会公益领域重点研发和成果转化项目(No.2022YFSH0123)。

摘　　要：目的分析我院血流感染病原菌分布及耐药情况,以对其诊断、治疗及防治提供参考。方法回顾性分析我院2017年1月至2022年12月的血流感染患者的临床资料和实验室数据。结果10012例血培养样本共分离出病原菌791株,其中革兰阴性杆菌334株(占42.22%),革兰阳性球菌361株(占45.64%),念珠菌14株(占1.77%)。前3位分离菌依次为大肠埃希菌(22.25%)、凝固酶阴性葡萄球菌(CNS,19.6%)、肺炎克雷伯菌(9.73%)。大肠埃希菌及肺炎克雷伯菌产ESBL检出率分别为44.30%和22.7%;大肠埃希菌和肺炎克雷伯菌耐碳青霉烯类药物检出率分别为0.6%和1.3%;鲍曼不动杆菌和铜绿假单胞菌耐碳青霉烯类药物检出率分别为93.33%和6.67%;凝固酶阴性葡萄球菌和金黄色葡萄球菌甲氧西林耐药的检出率分别为84.52%和3.33%;尚未检出对万古霉素和利奈唑胺耐药的葡萄球菌属细菌、肠球菌属细菌和肺炎链球菌。结论我院血培养分离株以大肠埃希菌为主,产超广谱β-内酰胺酶为主要耐药现象,大肠埃希菌和肺炎克雷伯菌对碳青霉烯类耐药有所上升,需要临床重视耐药菌的产生,合理使用抗生素。Objective In order to improve clinical diagnosis,treatment,and prevention of bloodstream infections(BSIs),we would like to study the distribution and drug resistance of bacteria isolated from BSIs in our hospital.Methods A retrospective study will be conducted to review and analyze clinical and laboratory data from patients with BSIs treated at our institution between January 2017 and December 2022.Results A total of 791 bacterial strains were isolated from 10,012 blood culture samples,including Gram-negative bacteria(334,42.22%),Grampositive bacteria(361,45.64%)and Candida(14,1.77%).The top 3 isolated bacteria are Escherichia coli(22.25%),CNS(19.6%),and Klebsiella pneumoniae(9.73%).The ESBL detection rates of Escherichia coli and Klebsiella pneumoniae were 44.30%and 22.7%.The carbapenem-resistant Escherichia coli and Klebsiella pneumoniae were 0.6%and 1.3%.The carbapenem-resistant Acinetobacter baumannii and Pseudomonas aeruginosa were 93.33%and 6.67%.The prevalence of MRSA and MRCNS were 84.52%and 3.33%.Staphylococcus,Enterococcus,and Streptococcus pneumoniae resistant to vancomycin and linezolid have not been detected yet.Conclusion Escherichia coli was the most common pathogen in bloodstream infections(BSIs)at our hospital,and the ESBL was the primary cause of medication resistance.Escherichia coli and Klebsiella pneumoniae had increased resistance to carbapenem.Clinical attention should be paid to the production of drug-resistant bacteria and rational use of antibiotics.

关 键 词：血流感染 病原菌分布 耐药性 血培养 抗菌药物 

分 类 号：R978[医药卫生—药品]