摘要
目的分析血培养病原菌阳性标本的病原菌分布特征及药物敏感性,为临床合理用药提供依据。方法回顾性分析广州医科大学附属顺德医院2020年全部血培养病原菌阳性标本。采用BACT/ALERT 3D全自动微生物检测系统与配套培养瓶、VITEK2 Compact全自动微生物分析系统进行血液培养、病原菌鉴定及药敏试验。按CLSI 2018文件标准判定结果,Microsoft Excel 2010软件对数据进行整理、统计和分析。结果2020年共收集血培养标本2098份,分离病原菌246株,分离率11.73%。革兰阴性菌178株,以为大肠埃希菌、肺炎克雷伯菌为主;革兰阳性菌67株,以凝固酶阴性葡萄球菌、金黄色葡萄球菌为主;真菌1株,为马尔尼菲青霉菌。主要分布科室为呼吸与危重症医学科、重症医学科和消化内科。两种肠杆菌科细菌均对青霉素类药物(哌拉西林)耐药,但对多黏菌素E(PE)、替加环素(TGC)敏感率高达100%。MRSA和MRCNS的检出率分别为36.8%、71.2%,未发现葡萄球菌属对利奈唑胺(LNZ)、替加环素(TGC)和万古霉素(VAN)耐药。结论该院血流感染病原菌种类相对较少,以革兰阴性菌为主,各临床科室间分布不一,不同病原菌间耐药率差异大。应加强对院内病原菌耐药性监测,以便指导临床合理用药。
Objective To analyze the distribution characteristics and drug sensitivity of pathogens in blood culture positive samples,so as to provide evidences for clinical rational use of antibiotics.Methods All the blood culture positive samples of Shunde Hospital affiliated to Guangzhou Medical University in 2020 were analyzed retrospectively.The blood samples were cultured by BACT/ALERT 3D automatic microbiological detection system and its matching blood culture bottles.The strains identification and drug susceptibility tests were performed by VITEK2 Compact automatic microbiological analysis system.Results of drug resistance were analyzed according to CLSI 2018 breakpoints and Microsoft Excel 2010 software was applied for data collation and statistical analysis.Results A total of 2,098 blood culture samples were collected in 2020,from which 246 strains of pathogenic bacteria were isolated,with an isolation rate of 11.73%.There were 178 Gram-negative bacteria,mainly Escherichia coli and Klebsiella pneumoniae,and 67 Gram-positive bacteria,mainly coagulase negative staphylococci and Staphylococcus aureus,as well as 1 fungus,Penicillium marneffei.The main distribution departments were Respiratory and Critical Medicine,Critical Medicine and Gastroenterology.Both Enterobacteriaceae bacteria were resistant to penicillins(piperacillin),but the sensitive rates to polymyxin E(PE)and tegacycline(TGC)were up to 100%.Methicillin-resistant strains in S.aureus(MRSA)and coagulase negative Staphylococcus(MRCNS)accounted for 36.8%and 71.2%,respectively.No staphylococcal strains were found resistant to linezolid(LNZ),tegacycline(TGC)and vancomycin(VAN).Conclusion The pathogens of bloodstream infection in this hospital are relatively few,mainly Gram-negative bacteria,with different distribution among clinical departments and significant differences in drug resistance among different pathogens.The surveillance of drug resistance of pathogenic bacteria in the hospital should be strengthened in order to guide the rational use of drugs in cli
作者
余高平
尹小毛
赖少芬
简惠雯
王治伟
YU Gaoping;YIN Xiaomao;LAI Shaofen;JIAN Huiwen;WANG Zhiwei(Department of Clinical Laboratory, The Affiliated Shunde Hospital of Guangzhou Medical University, Foshan 528315, China)
出处
《标记免疫分析与临床》
CAS
2021年第4期600-603,670,共5页
Labeled Immunoassays and Clinical Medicine
基金
佛山市科技创新项目(1920001000717)。
关键词
血培养
血流感染
病原菌
药物敏感性分析
Blood culture
Bloodstream infection
Pathogen
Drug sensitivity analysis
