摘要
目的 了解尿毒症患者透析引发血流感染风险因素及感染病原菌分布和耐药性评估。方法 选取2017年1月至2020年12月在该院进行透析的723例患者作为研究对象。其中发生导管相关血流感染(CRBSI)患者72例,采用SPSS13.0软件分析引发血流感染风险因素,并对感染病原菌分布和耐药性进行评估。结果 分析发现,年龄、BMI指数、白蛋白水平、置管时间、是否合并糖尿病是引起CRBSI发生的危险因素。引起CRBSI的病原菌中,革兰阳性菌占43.06%以表皮葡萄球菌为主,革兰阴性菌占56.94%,以肺炎克雷伯菌为主。药敏分析发现,表皮葡萄球菌、金黄色葡萄球菌、溶血葡萄球菌对万古霉素、利奈唑胺和替加环素全部敏感;对青霉素G、苯唑西林、头孢呋辛的耐药率>70%;肺炎克雷伯菌、大肠埃希菌对头孢菌素类抗生素耐药率>70%,对亚胺培南和美罗培南均敏感;铜绿假单胞菌对头孢他啶和头孢吡肟的耐药率达到75.00%,对喹诺酮类也较高;鲍曼不动杆菌除头孢哌酮/舒巴坦、亚胺培南和美罗培南外,其他抗菌药物的体外药敏试验耐药率普遍>50.00%;结论 患者年龄、BMI指数、白蛋白水平、置管时间、是否合并糖尿病与CRBSI发生率密切相关,CRBSI病原菌以革兰阴性菌为主,且耐药较为严重。
Objective To investigate the risk factors of hemodialysis induced bloodstream infection in uremic patients and the distribution and drug resistance of pathogenic bacteria.Methods From January 2017 to December 2020,723 patients undergoing dialysis in our hospital were selected as research objects.The risk factors of bloodstream infection were analyzed by SPSS13.0 software,and the distribution and drug resistance of pathogens were evaluated.Results analysis showed that age,BMI index,albumin level,catheter duration,and diabetes mellitus were the risk factors for CRBSI.Among the pathogens causing CRBSI,gram positive bacteria accounted for 43.06%,mainly Staphylococcus epidermidis,gram negative bacteria accounted for 56.94%,mainly Klebsiella pneumoniae.Drug sensitivity analysis showed that Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus haemolyticus were all sensitive to vancomycin,linezolid and tigecycline;The resistance rate to penicillin G,oxacillin and cefuroxime was more than 70%;Klebsiella pneumoniae and Escherichia coli were more than 70% resistant to cephalosporins,and were sensitive to imipenem and meropenem;The resistance rate of Pseudomonas aeruginosa to ceftazidime and cefepime was 75.00%,and quinolones were also high;Except cefoperazone / sulbactam,imipenem and meropenem,the drug resistance rate of Acinetobacter baumannii in vitro was more than 50%.Conclusion The age,BMI index,albumin level,catheter duration,and diabetes mellitus are closely related to the incidence of CRBSI.CRBSI pathogens are mainly Gram-negative bacteria,and the drug resistance is more serious.
作者
宋玉印
徐华
Song Yu-yin;Xu Hua(Department of Clinical Laboratory,Panjin Liaoyou Baoshihua Hospital,Panjin,Liaoning 124010)
出处
《国外医药（抗生素分册）》
CAS
2022年第2期120-124,共5页
World Notes on Antibiotics
关键词
血流感染
风险因素
病原菌
耐药性
bloodstream infection
risk factors
pathogens drug
resistance
