血液透析治疗的尿毒症合并CRBSI患者的细菌培养及药敏结果分析  

Analysis of Bacterial Culture and Drug Sensitivity Results in Uremic Patients With CRBSI Undergoing Hemodialysis

作　　者：李家徽 李桂云 赵延香 汲壮 LI Jiahui;LI Guiyun;ZHAO Yanxiang;JI Zhuang(Department of Clinical Laboratory,Jinan Seventh People's Hospital,Jinan Shandong 250132,China)

机构地区：[1]济南市第七人民医院检验科,山东济南250132

出　　处：《中国卫生标准管理》2025年第1期169-172,共4页China Health Standard Management

摘　　要：目的探讨实施血液透析治疗的尿毒症合并导管相关性血流感染(catheter-related bloodstream infection,CRBSI)患者细菌培养结果及药敏结果。方法选取济南市第七人民医院2021年4月—2023年2月收治的90例实施血液透析治疗的尿毒症合并CRBSI患者作为研究对象。对患者的血培养以及药敏结果进行统计,并按照感染病原菌种类分为革兰阳性球菌以及革兰阴性杆菌;统计革兰阳性球菌、革兰阴性杆菌患者的耐药情况。结果90例患者均经过病原菌培养以及细菌鉴定。其中59例患者为革兰阳性球菌,占65.56%(59/90);以金黄色葡萄球菌最为常见,占52.54%(31/59)。31例患者为革兰阴性杆菌,占34.44%(31/90);以大肠埃希菌最为常见,占61.29%(19/31)。59例革兰阳性球菌患者敏感率较高的前3位药物分别为万古霉素(100%)、呋喃妥因(98.31%)和莫西沙星(81.36%),耐药率较高的前3位分别为青霉素G(89.83%)、莫西沙星(84.75%)和克林霉素(54.24%)。31例革兰阴性杆菌患者敏感率较高的前3位药物分别为头孢唑肟(96.77%)、亚胺培南(93.55%)和环丙沙星(93.55%),耐药率较高药物分别为氨苄西林(87.10%)、头孢西丁(80.65%)和头孢唑林(77.42%)。结论尿毒症合并CRBSI患者的病原菌以革兰阳性球菌最为常见,其中以金黄色葡萄球菌所占比例最高,在进行早期治疗时需要结合患者的具体情况并结合既往经验实施抗感染治疗,并结合具体的血培养以及药敏检查结果对用药方案进行有效调整。Objective To explore and analyze the bacterial culture and drug sensitivity results in uremic patients with catheter-related bloodstream infection(CRBSI)undergoing hemodialysis.Methods A total of 90 patients with uremia combined with CRBSI who underwent hemodialysis treatment in Jinan Seventh People's Hospital from April 2021 to February 2023 were selected as the research subjects.The results of blood culture and drug sensitivity results were analyzed,and the patients were divided into Gram-positivecocci and Gram-negativebacilli according to the types of pathogenic bacteria.The drug resistance ofGram-positivecocciand Gram-negativebacilli were analyzed.Results All the 90 patients underwent pathogen culture and bacterial identification.Among them,59 patients wereGram-positivecocci,accounting for 65.56%(59/90).Staphylococcusaureus was the most common,accounting for 52.54%(31/59).And 31 patients were Gram-negativebacilli,accounting for 34.44%(31/90).Escherichiacoli was the most common,accounting for 61.29%(19/31).Among 59 patients with Gram-positivecocci,vancomycin(100%),furantoin(98.31%)and moxifloxacin(81.36%)were the top 3 drugs with high sensitivity,and penicillin G(89.83%),moxifloxacin(84.75%)and clindamycin(54.24%)were the top 3 drugs with high resistance,respectively.Among the 31 patients with Gram-negativebacilli,the top 3 drugs with high sensitivity rate were cefzoxime(96.77%),imipenem(93.55%)and ciprofloxacin(93.55%),and the drugs with high resistance rate were ampicillin(87.10%),cefoxitin(80.65%)and cefzolin(77.42%),respectively.Conclusion Gram-positivecoccus is the most common pathogen of uremia combined with CRBSI,among which Staphylococcusaureus accounts for the highest proportion.In the early treatment,anti-infection treatment should be carried out in combination with the specific situation of patients and previous experience,and the medication regimen should be effectively adjusted in combination with specific blood culture and drug sensitivity test results.

关 键 词：血液透析 尿毒症 导管相关性血流感染 细菌培养 药敏结果 血培养 

分 类 号：R457[医药卫生—治疗学]