摘要
目的了解脑梗死恢复期患者血培养分离菌菌种分布及对抗菌药物的耐药性。方法对2015-2017年血培养分离的1 225株非重复菌株,按其来源分为脑梗组和非脑梗组,并对两组血培养分离病原菌的分布和药敏结果进行统计分析。结果脑梗组血培养阳性率(28.7%)显著高于非脑梗组(12.5%),两组菌种分布相似;两组葡萄球菌均未检出对万古霉素、利奈唑胺、替加环素耐药菌株,但脑梗组患者金黄色葡萄球菌和凝固酶阴性葡萄球菌甲氧西林耐药株(MRSA和MRCNS)的检出率高于非脑梗组;两组肠球菌对多数受试抗菌药物的耐药率>70%,其中高水平氨基糖苷类耐药率均为100%。非脑梗组患者分离的万古霉素耐药肠球菌(VRE)检出率为8.3%。非脑梗组患者分离株中碳青霉烯类耐药肺炎克雷伯菌显著高于脑梗组;两组患者的铜绿假单胞菌分离株对抗菌药物的耐药率大多相近,耐药率大多低于30%。结论脑梗死恢复期患者血培养阳性率明显高于同期住院患者,革兰阴性菌是脑梗死恢复期患者血流感染主要病原菌,脑梗组与非脑梗组患者血培养分离株对受试抗菌药物的敏感率有不同程度的差异,因此脑梗死恢复期患者血培养阳性时用药应考虑患者具体病情和分离菌株的药敏结果而定。
Objective To review the distribution of the pathogens isolated from blood culture in the patients with convalescent cerebral infarction from 2015 to 2017,and analyze the antimicrobial susceptibility profile of these strains.Methods A total of 1225 nonduplicate strains were isolated from blood culture during this period.The strains were analyzed in terms of the presence/absence of cerebral infarction.Results The positive rate of blood culture in the patients with cerebral infarction(28.7%)was significantly higher than that in the patients without cerebral infarction(12.5%).The distribution of bacterial pathogens was similar in the two groups.None of the Staphylococcus isolates in either group did not show resistance to vancomycin,linezolid,or tigecycline.The prevalence of methicillin-resistant strains(MRSA and MRCNS)was higher in the patients with cerebral infarction than that in the patients without cerebral infarction.More than 70%of the Enterococcus isolates were resistant to most of the antimicrobial agents tested in both groups.All the Enterococcus isolates(100%)were resistant to high level aminoglycosides.The prevalence of vancomycin-resistant Enterococcus(VRE)was 8.3%in the patients without cerebral infarction.The prevalence of carbapenemresistant Klebsiella pneumoniae in the patients without cerebral infarction was significantly higher than that in the patients with cerebral infarction.The Pseudomonas aeruginosa isolates in both groups of patients showed similar resistance rates to most antimicrobial agents,generally lower than 30%.Conclusions The positive rate of blood culture in the patients with convalescent cerebral infarction is significantly higher than the inpatients without cerebral infarction during the same period.Gram-negative bacilli are the main pathogens of bloodstream infection in convalescent patients with cerebral infarction.The antimicrobial susceptibility profile is different between the patients with cerebral infarction and those without cerebral infarction.The antimicrobial therapy for
作者
李晓君
谭俊青
潘慧娟
李蔼文
王康椿
LI Xiaojun;TAN Junqing;PAN Huijuan;LI Aiwen;WANG Kangchun(Department of Laboratory Medicine,the Second Traditional Chinese Medicine Hospital of Guangdong,Guangzhou 510095,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2018年第5期521-526,共6页
Chinese Journal of Infection and Chemotherapy
关键词
脑梗死
血培养
临床分布
药敏分析
cerebral infarction
blood culture
clinical distribution
antimicrobial susceptibility testing
