南宁某医院2020年—2023年血培养分离细菌分布及耐药性分析  

Distribution and Drug Resistance Analysis of Bacteria Isolated from Blood Culture in a Hospital in Nanning from 2020 to 2023

作　　者：罗艺兵 张建刚 付蕾 覃珊珊 曾江辉[1,2] Luo Yi-bing;Zhang Jian-gang;Fu Lei;Qin Shan-shan;Zeng Jiang-hui(The Second People’s Hospital of Nanning,Nanning 530031;Guangxi Key Laboratory of Molecular Immunology Research,Nanning 530031)

机构地区：[1]南宁市第二人民医院医学检验科,南宁530031 [2]广西分子免疫研究重点实验室,南宁530031

出　　处：《国外医药(抗生素分册)》2025年第1期59-64,共6页World Notes on Antibiotics

摘　　要：目的研究分析南宁地区某医院2020年—2023年血培养分离细菌的临床分布情况及对主要抗菌药物的耐药性,为临床抗感染方案的选择和院内感染的防控提供指导。方法收集2020年—2023年血培养分离的病原菌数据,依据美国临床和实验室标准化协会(CLSI)药敏试验执行标准,运用WHONET5.6软件对菌株的临床科室分布及耐药情况进行统计分析。结果57843份血培养标本共检出病原菌5332株,排除重复菌株后共检出病原菌1451株,其中革兰阳性菌27.3%,革兰阴性菌69.7%,真菌3.0%。菌株分布前5位的病原菌分别是大肠埃希菌499株(34.4%),肺炎克雷伯菌275株(18.9%),金黄色葡萄球菌139株(9.6%),凝固酶阴性葡萄球菌(CNS)117株(8.06%)和肠球菌属68株(4.7%)。甲氧西林耐药的金黄色葡萄球菌(MRSA)检出率为18.7%,甲氧西林耐药的凝固酶阴性葡萄球菌(MRCNS)的检出率为71.8%;MRCNS对左氧氟沙星和莫西沙星的耐药率高于MRSA,差异具有统计学意义(P<0.001)。碳青霉烯类耐药的肠杆菌科细菌(CRE)总检出率为4.67%,对碳青霉烯类耐药的铜绿假单胞菌(CRPA)和鲍曼不动杆菌(CRAB)检出率分别为3.3%和60%。未检出对万古霉素耐药的肠球菌及葡萄球菌。结论血流感染患者血培养分离细菌以革兰阴性菌为主,大肠埃希菌为最主要分离菌;不同细菌对抗菌药物的耐药性差异较大,准确及时地监测报告本地区血培养分离菌的分布及耐药情况,对于合理使用抗菌药物进行临床治疗具有重要指导意义。Objective In order to provide guidance for the selection of clinical anti-infection plans and the prevention and control of hospital infections,it is necessary to investigate and analyze the clinical distribution of bacteria isolated from blood culture in a specific hospital in Nanning between 2020 and 2023,as well as their resistance to major antibiotics.Method Collect pathogenic bacteria data isolated from blood culture from 2020 to 2023,and use WHONET5.6 software to statistically analyze the clinical department distribution and drug resistance of the strains according to the CLSI drug sensitivity test execution standards.Result A total of 5332 strains of pathogenic bacteria were detected in 57843 blood culture samples,and 1451 strains were detected after weight removal.Among them,27.3%are Gram positive bacteria,69.7%are Gram negative bacteria,and 3%are fungi.The top five pathogenic bacteria in terms of strain distribution are:275 strains of Klebsiella pneumoniae(18.9%).139 strains of Staphylococcus aureus(9.6%).68 strains of the Enterococcus genus(4.7%).499 strains of Escherichia coli(34.4%).117 strains of coagulase negative Staphylococcus(CNS)(8.06%).The detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 18.7%,and the detection rate of methicillin-resistant coagulase negative Staphylococcus(MRCNS)was 71.8%;The resistance rate of MRCNS to levofloxacin,Moxifloxacin was significantly higher than that of MRSA.The difference was statistically significant(P<0.001).While the detection rates of carbapenem-resistant Acinetobacter baumannii(CRAB)and Pseudomonas aeruginosa(CRPA)were 3.3%and 60%,respectively,the total detection rate of carbapenem-resistant Enterobacteriaceae bacteria(CRE)was 4.67%.Vancomycin resistant Enterococcus and Staphylococcus were not detected.Conclusion Escherichia coli is the most significant bacteria isolated from blood cultures of patients with bloodstream infections.Since different bacteria have varying degrees of drug resistance,it is possible to accurately and promptly m

关 键 词：血流感染 细菌耐药检测 病原菌 耐药性 血培养 

分 类 号：R446.5[医药卫生—诊断学]