急诊科脓毒症患者感染部位及血培养病原菌分布特点分析  

Analysis distribution characteristics of infection sites and blood culture pathogens in sepsis patients in the emergency department

作　　者：房巍 王真 FANG Wei;WANG Zhen(Department of Emergency,Emergency and Critical Care Medical Center,Beijing Shijitan Hospital,Capital Medical University,Beijing100038,China)

机构地区：[1]首都医科大学附属北京世纪坛医院急危重症医学中心急诊科,北京100038

出　　处：《中国医药导报》2025年第10期33-37,共5页China Medical Herald

摘　　要：目的分析急诊科脓毒症患者感染部位及血培养病原菌的分布特点,为临床早期合理选择抗菌药物提供参考。方法本研究为真实世界的研究,收集2021年5月至2023年5月首都医科大学附属北京世纪坛医院急诊科抢救室收治的378例脓毒症患者的临床资料及血培养结果,分析感染部位及血培养病原菌的分布特点。结果378例脓毒症患者,共计436个感染部位,85.71%患者为单个部位感染,14.29%患者同时合并多个(≥2个)部位感染。单个部位感染以呼吸系统最常见,占比87.65%,多个部位感染以呼吸系统合并泌尿系统最常见,占比60.00%。血培养标本送检率为55.56%,血培养阳性率为28.57%,共检出病原菌60株,其中革兰氏阴性菌占50.00%、革兰氏阳性菌占45.00%、真菌占5.00%,居于前3位的是大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌(33.33%、13.33%、10.00%)。结论急诊科脓毒症患者主要为单部位感染,最常见的感染部位为呼吸系统,血培养检测结果主要为革兰氏阴性菌,最常见的致病菌为大肠埃希菌。临床医师应对本地区脓毒症患者感染部位及血培养病原菌的分布特点进行定期监测,为早期合理选择抗菌药物提供参考。Objective To analyze the distribution characteristics of infection sites and blood culture pathogens in sepsis patients in the emergency department and to provide a reference for reasonably selecting antibiotics in the early clinical period.Methods This study was a real-world study.Clinical data and blood culture results of 378 sepsis patients admitted to the Department of Emergency,Beijing Shijitan Hospital,Capital Medical University from May 2021 to May 2023 were collected to analyze the infection site and the distribution characteristics of pathogenic bacteria in blood culture.Results The 378 sepsis patients had totally 436 infection sites,of which 85.71%had single-site infection,and 14.29%had multi-site(≥2)infections at the same time.The most common single-site infection was the respiratory system,accounting for 87.65%,and the most common multi-site infections were the respiratory-urinary system,accounting for 60.00%.The blood culture testing rate was 55.56%,and blood culture positive rate was 28.57%.A total of 60 pathogens were detected,of which Gram negative bacterium accounted for 50.00%,Gram positive bacterium accounted for 45.00%,and fungus accounted for 5.00%.The top three pathogens were Escherichia coli,Staphylococcus epidermidis,and Klebsiella pneumoniae(33.33%,13.33%,and 10.00%).Conclusion Sepsis patients in the emergency department mainly suffered from single-site infection,and the most common site is the respiratory system.Blood culture test results mainly show a high proportion of Gram negative bacterium,with Escherichia coli being the most common.Clinicians should regularly monitor the distribution characteristics of infection sites and blood culture pathogens of sepsis patients in their region,so as to provide a reasonable basis for the early rational selection of antibiotics.

关 键 词：脓毒症 感染部位 血培养 病原菌 

分 类 号：R446.5[医药卫生—诊断学]