某医院血培养中病原菌分布及耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in Blood Culture in a Hospital

作　　者：张晓晗 王晓飞 ZHANG Xiao-han;WANG Xiao-fei(Department of Laboratory,People's Hospital of Juye County,Shandong Province,Shandong Juye 274900)

机构地区：[1]山东省巨野县人民医院检验科,山东巨野274900 [2]济南市第四人民医院检验科,山东济南250000

出　　处：《医学检验与临床》2025年第2期45-51,共7页Medical Laboratory Science and Clinics

摘　　要：目的:分析巨野县人民医院血流感染病原菌的分布及耐药情况,加强病原菌的耐药监测,为临床经验性治疗血流感染提供科学依据。方法:采集2019年1月-2023年12月间送检的血培养信息,分析血流感染患者的一般资料(包括患者性别、年龄)、分布科室、感染部位、病死率及药敏等结果。结果:2019年1月-2023年12月这5年内的血培养阳性率15.7%,606例患者中,男性331例,女性275例,年龄小于等于18岁8例,占1.3%,19~60岁188例,占31.0%,大于60岁410例,占67.7%。住院期间死亡21例,病死率3.5%。最常见的继发血流感染的部位是肺部感染(238例,39.2%),其次是泌尿道感染(136例,22.4%)。科室分布以重症监护室为主(135例,22.3%),其次是呼吸内科(99例,16.3%),肿瘤科(51例,8.4%)等。606株病原菌中,革兰氏阴性菌(439,72.4%),革兰氏阳性菌(131,21.6%),真菌(14,2.3%),厌氧菌(22,3.6%)。居于前五位的分别是大肠埃希菌(40.1%)、肺炎克雷伯菌(9.4%)、金黄色葡萄球菌(7.9%)、凝固酶阴性的葡萄球菌(4.3%)、阴沟肠杆菌(4.0%)。大肠埃希菌和肺炎克雷伯菌对头孢哌酮/舒巴坦、厄他培南、亚胺培南、哌拉西林/他唑巴坦、美罗培南、替加环素、阿米卡星的耐药率均小于10%,革兰氏阳性菌以金黄色葡萄球菌为主,其次是凝固酶阴性的葡萄球菌,未监测到对利奈唑胺、万古霉素、替考拉宁、奎奴普丁/达福普汀以及替加环素耐药的金黄色葡萄球菌、凝固酶阴性的葡萄球菌、肠球菌以及链球菌。结论:我院送检的血培养中,病原菌以革兰氏阴性菌为主,其中大肠埃希菌和肺炎克雷伯菌最常见,当发生血流感染时,临床医生应结合本院以及本地区的细菌耐药情况选择抗菌药物,这样才能有效地控制耐药菌株的出现。Objective:To analyze the distribution and drug resistance of pathogenic bacteria of bloodstream infection in Juye People's Hospital,strengthen the monitoring of drug resistance of pathogenic bacteria,and provide scientific basis for clinical empirical treatment of bloodstream infection.Methods:From January 2019 to December 2023,the general data(including gender and age of patients),distribution departments,infection sites,mortality rate and drug sensitivity of bloodstream infection patients were analyzed.Results:In the five years from January 2019 to December 2023,the positive rate of blood culture was 15.7%.Among the 606 patients,331 were male and 275 were female,8 were less than or equal to 18 years old,accounting for 1.3%,188 were 19~60 years old,accounting for 31.0%,and 410 were more than 60 years old.21 cases died during hospitalization,with a mortality rate of 3.5%.The most common site of secondary bloodstream infection was pulmonary infection(238 cases,39.2%),followed by urinary tract infection(136 cases,22.4%).Intensive care unit was the main department(135 cases,22.3%),followed by respiratory medicine(99 cases,16.3%)and oncology(51 cases,8.4%).The pathogens included gram-negative bacteria(439,72.4%),gram-positive bacteria(131,21.6%),fungi(14,2.3%)and anaerobic bacteria(22,3.6%).The top five pathogens were Escherichia coli(40.1%),Klebsiella pneumoniae(9.4%),Staphylococcus aureus(7.9%),coagulase-negative Staphylococcus(4.3%)and Enterobacter cloacae(4.0%).The resistance rates of Escherichia coli and Klebsilla pneumoniae to cefoperazone/sulbactam,ertapenem,imipenem,piperacilin/tazobactam,meropenem,tigecycline and amikacin were less than 10%.Gram-positive bacteria were mainly Staphylococcus aureus,followed by coagulase-negative Staphylococcus.Staphylococcus aureus,coagulase-negative staphylococci,enterococci,and streptococci resistant to linezolid,vancomycin,teicoplanin,quinupristin/dalfopristin,and tigecycline were not detected.Conclusion:In the blood culture of our hospital,the pathogens were mainly gram-ne

关 键 词：血培养 病原菌 耐药性 血流感染 

分 类 号：R44[医药卫生—诊断学]