某院血流感染血培养病原菌的分布以及药敏性分析  

Analysis of the Distribution and Antibiotic Susceptibility of Pathogenic Bacteria Isolated from Blood Cultures for Bloodstream Infections in a Certain Hospital

作　　者：王海燕[1] 程绍云[1] 王珍妮 WANG Haiyan;CHENG Shaoyun;WANG Zhenni(Department of Clinical Laboratory,The Third People’s Hospital of Qingdao,Qingdao,Shandong,266041,China)

机构地区：[1]青岛市第三人民医院检验科,山东青岛266041

出　　处：《中国医药指南》2025年第11期52-55,共4页Guide of China Medicine

摘　　要：目的探讨某院肝胆科、泌尿科、急诊科以及ICU血培养病原菌的分布特征及耐药性。方法回顾性分析2020年1月至2024年9月青岛市第三人民医院肝胆科、泌尿科、急诊科以及ICU发生的血流感染患者的病原菌分布及药敏结果。结果肝胆科、泌尿科、急诊科以及ICU血培养阳性率分别为19.54%、18.16%、23.72%和8.47%。革兰阴性菌前3位是大肠埃希菌、肺炎克雷伯杆菌和铜绿假单胞菌。肝胆科占有优势的革兰阳性菌为肠球菌属和凝固酶阴性葡萄球菌(CNS)。泌尿科革兰阳性菌较少,主要为CNS。急诊科以CNS为主,其次为金黄色葡萄球菌。ICU与急诊科相似。大肠埃希菌及肺炎克雷伯杆菌对β-内酰胺类/β-内酰胺酶抑制剂复方制剂、氨基糖苷类以及碳青霉烯类抗生素的敏感度高,常见革兰阳性菌对达托霉素、利奈唑胺、万古霉素等敏感度高。结论不同科室血流感染的病原菌分布及耐药性存在一定的差异,定期监测血培养阳性标本的病原菌的分布特征和耐药情况,有助于为临床早期合理的经验性用药提供依据。Objective To investigate the distribution characteristics and antimicrobial resistance of pathogenic bacteria in blood cultures in the hepatobiliary department,urology department,emergency department,and intensive care units(ICU)of a certain hospital.Methods The pathogenic bacteria distribution and drug susceptibility results of patients with bloodstream infections in the hepatobiliary department,urology department,emergency department,and ICU of the third people’s hospital of qingdao from January 2020 to September 2024 were retrospectively analyzed and compared.Results The blood culture positive rates in the hepatobiliary,urology,emergency,and ICU departments were 19.54%,18.16%,23.72%,and 8.47%,respectively.The top three gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae,and Pseudomonas aeruginosa.In the hepatobiliary department,dominant gram-positive bacteria were Enterococcus and coagulase-negative Staphylococcus(CNS).In the urology department,gram-negative bacteria outnumbered gram-positive bacteria(mainly CNS).In the emergency department,CNS was the main gram-positive bacteria,followed by Staphylococcus aureus,and the ICU had similar top gram-positive bacteria.Escherichia coli and Klebsiella pneumoniae were highly sensitive toβ-lactam/β-lactam inhibitor combinations,aminoglycosides,and carbapenems.Gram-positive bacteria like Staphylococcus and Enterococcus were highly sensitive to daptomycin,linezolid,and vancomycin.Conclusions There exist certain disparities in the distribution and drug resistance patterns of pathogenic bacteria in bloodstream infections across diverse departments.Regular monitoring of the distribution characteristics and drug resistance of pathogenic bacteria is necessary for the rational selection of appropriate antibiotics in the early clinical stage.

关 键 词：血流感染 血培养 病原菌 耐药 

分 类 号：R446.5[医药卫生—诊断学]