云阳县人民医院血培养常见细菌的分布及耐药性分析  

Distribution and antimicrobial resistance of bacterial strains isolated from blood culture at Yunyang County People's Hospital

作　　者：罗根 韩林妍 廖兰 王若愚 陈飞帆 谭孝忠 樊恩情 陈志军 潘彬 LUO Gen;HAN Linyan;LIAO Lan;WANG Ruoyu;CHEN Feifan;TAN Xiaozhong;FAN Enqing;CHEN Zhijun;PAN Bin(Department of Laboratory Medicine,Yunyang County People's Hospital,Chongqing 404500,China)

机构地区：[1]云阳县人民医院医学检验科,重庆404500

出　　处：《中国感染与化疗杂志》2025年第1期70-77,共8页Chinese Journal of Infection and Chemotherapy

摘　　要：目的 了解2019—2023年云阳县人民医院住院患者血培养分离常见细菌的分布特点和耐药性。方法 回顾性分析2019—2023年云阳县人民医院血培养分离常见细菌的抗菌药物敏感性试验结果和耐药性。结果 血培养分离菌共3 789株,其中革兰阴性菌1 931株(51.0%),革兰阳性菌1 858株(49.0%)。凝固酶阴性葡萄球菌(33.3%)、大肠埃希菌(25.4%)、肺炎克雷伯菌(13.7%)、金黄色葡萄球菌(9.9%)、阴沟肠杆菌(1.8%)位列前5位。药敏试验结果显示,金黄色葡萄球菌、表皮葡萄球菌和其他凝固酶阴性葡萄球菌中甲氧西林耐药株的检出率分别为27.1%、34.5%和49.9%。甲氧西林耐药株(MRSA、MRSE和其他MRCNS)对大多数抗菌药物的耐药率明显高于甲氧西林敏感株(MSSA、MSSE和其他MSCNS)。葡萄球菌属未检出对万古霉素、替考拉宁、利奈唑胺和替加环素耐药菌株。肠球菌属中屎肠球菌对抗菌药物的耐药率明显高于粪肠球菌,两菌中均未检出对万古霉素、替考拉宁、利奈唑胺和替加环素耐药株。所有链球菌属细菌均未发现对万古霉素和利奈唑胺耐药者。肠杆菌目中,除了黏质沙雷菌对碳青霉烯类药物的耐药率达25.0%以外,其他菌属对碳青霉烯类药物的耐药率均<10.0%。肠杆菌目细菌均未发现对替加环素耐药。铜绿假单胞菌对亚胺培南和美罗培南的耐药率分别为5.7%和3.8%,未检出对黏菌素类耐药的菌株。鲍曼不动杆菌对亚胺培南和美罗培南的耐药率分别为41.4%和38.0%。结论 血培养分离革兰阴性菌较革兰阳性菌略为多见。MRSA和MRCNS的检出率较高,鲍曼不动杆菌和黏质沙雷菌对碳青霉烯类药物耐药率高。应加强对医院血培养分离细菌的耐药监测,根据药敏试验结果合理使用抗菌药物,防止耐药菌的传播。Objective To understand the distribution and antimicrobial resistance profiles of bacterial strains isolated from blood cultures at Yunyang County People's Hospital from 2019 to 2023.Methods The data of bacterial isolates from blood samples and the results of antimicrobial susceptibility testing were analyzed retrospectively from 2019 to 2023 at Yunyang County People's Hospital.Results A total of 3789 bacterial strains were isolated from blood culture,including 1931(51.0%)strains of Gram negative bacteria and 1858(49.0%)strains of Gram positive bacteria.Coagulase negative Staphylococcus(33.3%),Escherichia coli(25.4%),Klebsiella pneumoniae(13.7%),Staphylococcus aureus(9.9%),and Enterobac ter cloacae(1.8%)were the top five bacterial pathogens.Antimicrobial susceptibility testing showed that the prevalence of methicillin-resistant strains was 27.1%in S.aureus,34.5%in S.epidermidis,and 49.9%in other coagulase-negative Staphylococcus.Methicillin resistant strains(MRSA,MRSE,and other MRCNS)showed significantly higher resistance rates to most antibiotics than corresponding methicillin-susceptible strains(MSSA,MSSE,and other MSCNS).No staphylococcal isolates were resistant to vancomycin,teicoplanin,linezolid,or tigecycline Enterococcus faecium showed significantly higher resistance rate to antibiotics than Enterococcus faecalis.No enterococcal strains were resistant to vancomycin,teicoplanin,linezolid,or tigecycline.No streptococcal isolates were found resistant to vancomycin or linezolid.Serratia marcescens strains had a resistance rate of 25.0%to carbapenems.All other Enterobacterales species showed a resistance rate of less than 10.0%to carbapenems.No Enterobacterales isolates were found resistant to tigecycline.The resistance rates of P.aeruginosa to imipenem and meropenem were 5.7%and 3.8%,respectively.No P.aeruginosa isolates were found resistant to colistin.The resistance rates of Acinetobacter baumanni to imipenem and meropenem were 41.4%and 38.0%,respectively.Conclusions The proportion of Gram negative bacteria

关 键 词：血培养 耐药细菌 抗菌药物 耐药性监测 

分 类 号：R378[医药卫生—病原生物学]