梧州市某医院ICU血流感染患者病原学特征及耐药分析  

Analysis of pathogenic characteristics and drug resistance of bloodstream infection patients in ICU of a hospital in Wuzhou city

作　　者：周观娇 吴庆梅 陈建欢 邓泽群 林杰 覃钦 黄中坚 刘端绘 ZHOU Guanjiao;WU Qingmei;CHEN Jianhuan;DENG Zequn;LIN Jie;QIN Qin;HUANG Zhongjian;LIU Duanhui(Wuzhou Gongren Hospital,Wuzhou 543001;Wuzhou Red Cross Hospital,Wuzhou 543002,China)

机构地区：[1]梧州市工人医院,广西梧州543001 [2]梧州市红十字会医院,广西梧州543002

出　　处：《临床医学研究与实践》2025年第10期46-49,共4页Clinical Research and Practice

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(No.Z-D20221718);梧州市科技计划项目(No.202102075)。

摘　　要：目的探讨梧州市某医院ICU血流感染(BSI)患者的病原学特征及耐药情况。方法收集2021年11月至2023年11月血培养阳性且确诊为BSI的200例患者的临床资料,患者均进行细菌培养、药敏试验。分析BSI患者的病原菌分布特征;分析主要革兰阴性菌、革兰阳性菌对临床常用抗菌药物的耐药率。结果200例BSI患者中,革兰阴性菌82株(41.00%),革兰阳性菌50株(25.00%),真菌38株(19.00%),病毒30株(15.00%)。主要的革兰阴性菌中,鲍曼不动杆菌对美罗培南和亚胺培南的耐药率分别为70.00%和60.00%;肺炎克雷伯菌对美罗培南和莫西沙星的耐药率分别为54.55%和45.45%;嗜麦芽寡养单胞菌对莫西沙星的耐药率为10.00%,对其余抗菌药物的耐药率均在30.00%及以上;大肠埃希菌对头孢哌酮/舒巴坦的耐药率高达66.67%。主要的革兰阳性菌中,肺炎链球菌对哌拉西林/他唑巴坦和阿米卡星的耐药率分别为46.67%和40.00%;金黄色葡萄球菌对氨苄西林的耐药率高达100.00%;屎肠球菌对头孢哌酮/舒巴坦和美罗培南的耐药率均为100.00%;纹带棒状杆菌对哌拉西林/他唑巴坦和头孢哌酮/舒巴坦的耐药率均达100.00%。结论梧州市工人医院ICU BSI病原菌以革兰阴性菌为主,其次是革兰阳性菌,且均存在显著的耐药性。临床需重视早期诊断和个体化治疗,加强感染控制,以减少感染率、提升患者的生存率。Objective To investigate the pathogenic characteristics and drug resistance of bloodstream infection(BSI)patients in the ICU of a hospital in Wuzhou city.Methods The clinical data of 200 patients with positive blood culture and confirmed BSI from November 2021 to November 2023 were collected.All patients underwent bacterial culture and drug sensitivity test.The distribution characteristics of pathogenic bacteria in BSI patients were analyzed;the drug resistance rates of main Gram-negative bacteria and Gram-positive bacteria to commonly used antibiotics in clinic were analyzed.Results Among the 200 patients with BSI,there were 82 strains(41.00%)of Gram-negative bacteria,50 strains(25.00%)of Gram-positive bacteria,38 strains(19.00%)of fungi and 30 strains(15.00%)of viruses.Among the main Gram-negative bacteria,the resistance rates of Acinetobacter baumannii to meropenem and imipenem were 70.00%and 60.00%,respectively;the resistance rates of Klebsiella pneumoniae to meropenem and moxifloxacin were 54.55%and 45.45%,respectively;the resistance rate of Stenotrophomonas maltophilia to moxifloxacin was 10.00%,and the resistance rates of other antibiotics were 30.00%and above;the resistance rate of Escherichia coli to cefoperazone/sulbactam was as high as 66.67%.Among the main Gram-positive bacteria,the resistance rates of Streptococcus pneumoniae to piperacillin/tazobactam and amikacin were 46.67%and 40.00%,respectively;the resistance rate of Staphylococcus aureus to ampicillin was as high as 100.00%;the resistance rates of Enterococcus faecium to cefoperazone/sulbactam and meropenem were 100.00%;the resistance rates of Corynebacterium striatum to piperacillin/tazobactam and cefoperazone/sulbactam were reaching 100.00%.Conclusion In the ICU of Wuzhou Gongren Hospital,Gram-negative bacteria are the main pathogens of BSI,followed by Gram-positive bacteria,both demonstrating significant antimicrobial resistance.Clinical attention should be paid to early diagnosis and individualized treatment,and infection control should be

关 键 词：血流感染 ICU 病原学特征 

分 类 号：R378[医药卫生—病原生物学]