2022年三级综合医院血培养检测结果分析  

作　　者：牛付轩 黄俊伟 洪迪 

机构地区：[1]浙江大学医学院附属金华医院,321000

出　　处：《浙江临床医学》2024年第12期1844-1846,共3页Zhejiang Clinical Medical Journal

基　　金：金华市科技计划项目(2021-3-050);浙江省医药卫生科技计划项目(2022KY1327)。

摘　　要：目的分析本院血培养送检阳性病原菌的感染分布及耐药情况,为临床早期经验性预防用药提供帮助。方法回顾性分析2022年1月至12月本院就诊并送检血培养患者的临床资料,进行病原菌分布及耐药性分析。结果送检血培养检测患者共9363例,阳性率为12.76%,其中分离率较高的为凝固酶阴性葡萄球菌(CNS)(30.45%)、大肠埃希菌(18.18%)、肺炎克雷伯菌(11.80%)和金黄色葡萄球菌(5.69%),科室分布以急诊抢救病区和重症医学科病区为主。复数菌感染占比10.96%,以肺炎克雷伯菌、大肠埃希菌和鲍曼不动杆菌为主。部分革兰阴性菌株耐碳青霉烯类及头孢菌素类抗生素,常见革兰阳性菌检出青霉素和红霉素耐药菌株,耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为34.94%。念珠菌对氟康唑和伊曲康唑耐药率分别为21.62%、18.92%。结论血培养报阳率高,血流感染患者菌株分布广泛,复数菌感染可见,耐药率高,同时血培养的污染不容忽视,临床应合理使用抗菌药物,采取有效措施降低血培养的污染率。Objective To analyze the infection distribution and drug resistance of positive pathogens detected by blood culture in our hospital,so as to provide help for early clinical empirical use and assist in monitoring hospital infection.Methods The clinical data of patients who were admitted to our hospital and sent for blood culture from January to December 2022 were retrospectively analyzed,and the distribution and drug resistance of pathogens were analyzed.Results A total of 9363 patients were tested for blood culture,with a positive rate of 12.76%.Coagulase negative Staphylococcus(CNS)(30.45%),Escherichia coli(18.18%),Klebsiella pneumoniae(11.80%)and Staphylococcus aureus(5.69%)were the most common pathogens isolated.The distribution of departments was mainly in the emergency rescue ward and the critical care medicine ward.Polymicrobial infection accounted for 10.96%,mainly Klebsiella pneumoniae,Escherichia coli and Acinetobacter baumannii.Some gram-negative strains were resistant to carbapenems and cephalosporins.Penicillin and erythromycin resistant strains were detected in common Gram-positive bacteria,and the detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 34.94%.The resistance rates of Candida to fluconazole and itraconazole were 21.62%and 18.92%,respectively.Conclusion The positive rate of blood culture in our hospital is high,the strains of patients with bloodstream infection are widely distributed,the plural bacteria infection is visible,and the drug resistance situation is serious.At the same time,the contamination of blood culture can not be ignored.Clinical departments should rationally use antibacterial drugs and take effective measures to reduce the contamination rate of blood culture.

关 键 词：血流感染 病原菌分布 复数菌 污染率 耐药性分析 

分 类 号：R446.5[医药卫生—诊断学]