摘要
目的分析自贡市第四人民医院血流感染病原菌的分布及耐药性,为临床诊疗提供依据。方法回顾性分析自贡市第四人民医院2018年1月-2018年12月血培养标本的科室分布、感染来源、病原菌分布及耐药性等。结果共收集11 507份血培养标本,共检出病原菌496株,阳性率为4.31%。病原菌主要来自肾病内科、肝胆科、重症医学科,阳性率较高的科室主要为脑外科、泌尿外科、肝胆科。病原菌主要来自尿路感染,构成比为39.94%,其次为原发性脓毒血症、胆道感染和肺部感染。革兰阴性菌361株,构成比为72.78%,主要为大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌;革兰阳性菌115株,构成比为23.19%,主要为金黄色葡萄球菌和表皮葡萄球菌;真菌20株,构成比为4.03%。大肠埃希菌和肺炎克雷伯菌对厄他培南、阿米卡星、亚胺培南、哌拉西林/他唑巴坦和头孢替坦的耐药率较低,均小于10%,大肠埃希菌对氨苄西林、头孢唑啉的耐药率较高,均大于60%;肺炎克雷伯菌除对头孢唑啉的耐药率为26.19%,对其他常用抗菌药物的耐药率均低于20%;铜绿假单胞菌除对亚胺培南的耐药率为12.50%,对哌拉西林的耐药率为25.00%外,对其他常用抗菌药物的耐药率均低于10%。金黄色葡萄球菌和表皮葡萄球菌对利奈唑胺、替加环素、万古霉素、喹奴普汀/达福普汀完全敏感,金黄色葡萄球菌还对莫西沙星、利福平、环丙沙星和左氧氟沙星完全敏感。金黄色葡萄球菌和表皮葡萄球菌对克林霉素、红霉素和青霉素的耐药率均高于70%。结论自贡市第四人民医院血培养存在阳性率低、送检率低等问题,需要针对相应的科室进行沟通,改善目前的血培养送检情况,并定期对血流感染病原菌的分布及耐药性进行分析,为临床医生经验用药提供依据。
Objective To analyze the distribution and drug resistance of pathogenic bacteria of bloodstream infection in Zigong Fourth People’s Hospital, for providing evidence for clinical diagnosis and treatment. Methods Distribution of departments, source of infection, the distribution, and drug resistance of pathogenic bacteria in Zigong Fourth People’s Hospital from January to December 2018 were retrospectively analyzed. Results A total of 496 strains of pathogens were isolated from 11 507 blood culture samples with the positive rate of 4.31%. They were mainly from Department of Nephrosis Internal Medicine, Department of Hepatology, and Department of Critical Care Medicine. Department of Cerebral Surgery, Department of Urological Surgery, and Department of Hepatology had the higher positive rate. The primary pathogens were from urinary tract infection, accounting for 39.94%, followed by primary sepsis, biliary tract infection, and pulmonary infection. Gram-negative bacteria were 361 strains(72.78%), and main of them were Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa. Gram-positive bacilli(115 strains) accounted for 23.19%, and main of them were Staphylococcus aureus and Staphylococcus epidermidis. And fungi(20 strains) accounted for 4.03%. E. coli and K. pneumonia had lower drug resistance rate against ertapenem, amikacin, imipenem, piperacillin/tazobactam, and cefotetan, and the drug resistance rate was lower than 10%. The drug resistance rate of E. coli against ampicillin and cefazolin were higher than 60%. The drug resistance rate of K. pneumonia against cefazolin was 26.19%, while the drug resistance rate against other common antibacterial drugs were lower than 20%. The drug resistance rate of P. aeruginosa against imipenem was 12.50%, and against piperacillin was 25.00%, while the drug resistance rate against other common antibacterial drugs were lower than 10%. S. aureus and S. epidermidis were completely sensitive to linezolid, tigecycline, vancomycin, quinupristin/dalfopristin. S. aureus
作者
龙小平
李玉梅
LONG Xiao-ping;LI Yu-mei(Department of Laboratory Medicine,Zigong Fourth People’s Hospital,ZiGong 643000,China)
出处
《现代药物与临床》
CAS
2019年第10期3159-3163,共5页
Drugs & Clinic
关键词
抗菌药物
血培养
病原菌
耐药性
antibacterial drugs
blood culture
pathogenic bacteria
drug resistance
