摘要
目的回顾分析四川地区住院患者血流感染(bloodstream infection,BSI)中非发酵菌的病原菌分布和常见抗生素敏感性结果,探讨四川地区血流感染中非发酵菌的病原学特征。方法收集2015年1月1日至2017年12月31日四川地区9家三甲医院所有血培养分离的非发酵菌,回顾性分析其菌种分布和耐药情况。结果共纳入分离出病原菌6 291株。其中,革兰阴性菌3 674株(58.4%),革兰阳性菌2 617株(41.6%),革兰阳性菌中葡萄球菌属1 895株(30.1%),链球菌372株(5.9%),肠球菌317株(5.1%),其他革兰阳性菌33株(0.5%)。革兰阴性菌中肠杆菌科3 191株(50.7%),非发酵菌389株(6.2%),其他革兰阴性菌94株(1.5%)。非发酵菌中分离率前三位的菌株依次为铜绿假单胞菌(136株,35.0%)、鲍曼不动杆菌(126株,32.4%)、嗜麦芽窄食单胞菌(33株,8.5%);非发酵菌在内科、ICU和外科中的分布为167株(42.9%)、112株(28.8%)和82株(21.1%)。铜绿假单胞菌对头孢吡肟、环丙沙星、庆大霉素的耐药率分别为16.5%、10.7%、9.9%,耐碳青霉烯类铜绿假单胞菌(carbapenems-resistant Pseudomonas aeruginosa,CR-PA)分离率为13.6%,未见对多黏菌素耐药菌株;鲍曼不动杆菌对除米诺环素和多黏菌素之外的抗生素耐药率均超过30%,耐碳青霉烯鲍曼不动杆菌(carbapenems-resistant Acinetobacter baumannii,CR-AB)分离率为75.7%。嗜麦芽窄食单胞菌对左旋氧氟沙星、复方新诺明和头孢他啶的耐药率分别为0%、0%和37.0%,洋葱伯克霍尔德菌对左旋氧氟沙星、复方新诺明和头孢他啶的耐药率分别为10.5%、4.2%、19%,均未超过30%。结论四川地区血流感染中非发酵菌的分离率为6.2%,以铜绿假单胞菌、鲍曼不动杆菌为主,多分离于内科患者。非发酵菌在临床科室间分布的差异较大,鲍曼不动杆菌多重耐药菌检出率高,其他非发酵菌抗生素敏感性较好。
Objective To retrospectively analyze the distribution of non-fermentative bacteria causing bloodstream infection in hospitalized patients in Sichuan Province and their drug susceptibility to common antibiotics for better understanding their epidemiological characteristics. Methods From January 1, 2015 to December 31, 2017, all of the non-fermentative bacteria isolated from patients with bloodstream infection in nine hospitals in Sichuan Province were collected. Species distribution and drug resistance test results were retrospectively analyzed. Results A total of 6 291 strains of pathogenic bacteria were isolated, including 3 674 strains of gram-negative bacteria (58.4%) and 2 617 strains of gram-positive bacteria (41.6%). The gram-positive bacteria were 1 895 strains of Staphylococcus (30.1%), 372 strains of Streptococcus (5.9%), 317 strains of Enterococcus (5.1%) and 33 strains of other gram-positive bacteria (0.5%). The gram-negative bacteria were 3 191 Enterobacteriaceae strains (50.7%), 389 non-fermentative strains (6.2%) and 94 other gram-negative strains (1.5%). The isolated non-fermentative bacteria were mainly Pseudomonas aeruginosa (136 strains, 35.0%), Acinetobacter baumannii (126 strains, 32.0%) and Stenotrophomonas maltophilia (33 strains, 8.5%). There were 167 (42.9%), 112 (28.8%) and 82 (21.1%) non-fermentative bacteria isolated in internal medicine departments, ICUs and surgery departments, respectively. The drug resistance rates of Pseudomonas aeruginosa to cefepime, ciprofloxacin and gentamicin were 16.5%, 10.7% and 9.9%, respectively. Carbapenems-resistant Pseudomonas aeruginosa (CR-PA) accounted for 13.6%. No polymyxin-resistant Pseudomonas aeruginosa was found. The resistance rates of Acinetobacter baumannii to all antibiotics were over 30% except for minocycline and polymyxin and 75.7% of carbapenem-resistant Acinetobacter baumannii (CR-AB) were isolated. The drug resistance rates to levofloxacin, trimethoprim/sulfamethoxazole and ceftazidime were 0%, 0% and 37.0% in Stenotrophomonas maltoph
作者
王远芳
敖科萍
黄学东
邓杰伦
谢轶
吴贤丽
黄梅
蒋香梅
温晓峥
应军
李海军
向尹
徐雪梅
Wang Yuanfang;Ao Keping;Huang Xuedong;Deng Jielun;Xie Yi;Wu Xianli;Huang Mei;Jiang Xiangmei;Wen Xiaozheng;Ying Jun;Li Haijun;Xiang Yin(Laboratory of Clinical Microbiology, West China Hospital, Sichuan Hospital, Chengdu 610001, China;Clinical Laboratory of Panzhihua Central Hospital, Panzhihua 617000, China;Clinical Laboratory of Luzhou People′s Hospital, Luzhou 646000, China;Clinical Laboratory of Deyang People′s Hospital, Deyang 618000, China;Clinical Laboratory of Guang′an People′s Hospital, Guang′an 638500, China;Clinical Laboratory of Santai People′s Hospital, Mianyang 621100, China;Clinical Laboratory of Guangyuan Central Hospital, Guangyuan 628000, China;Clinical Laboratory of Leshan People′s Hospital, Leshan 614000, China;Clinical Laboratory of Leshan People′s Hospital, Leshan 614000, China)
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2019年第9期698-704,共7页
Chinese Journal of Microbiology and Immunology
关键词
血培养
多中心
非发酵菌
Blood culture
Multicenter
Non-fermentative bacteria
