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住院人群血流感染患者致病菌分布及耐药性分析

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  • NETL
  • NSTL
  • 万方数据
  • 维普
目的 分析住院人群血流感染(BSI)患者中致病菌分布及其耐药性情况。方法 选择住院人群中 129 例可疑BSI患者为研究对象，送检血培养标本共计有 4688 份，对患者的血液标本进行致病菌检测及药物敏感性试验，分析致病菌的检出、分布及耐药性情况。结果 送检标本剔除重复菌株，检出病原菌 335 株，菌株阳性率为 7。15%(335/4688)。病原菌以革兰阴性(G-)菌居多，以大肠埃希氏菌、肺炎克雷伯菌、金黄色葡萄球菌占比较多，分别为 48。96%、14。63%、10。75%。共检出G-菌253 株，革兰阳性(G+)菌 82 株;血培养分离G-菌中大肠埃希氏菌对阿米卡星、美罗培南、哌拉西林/他唑巴坦、替加环素、替卡西林/克拉维酸、头孢哌酮/舒巴坦、亚胺培南的药物敏感率分别为96。34%、100。00%、96。34%、100。00%、90。24%、92。07%、100。00%，均在 90%以上，对氨苄西林、头孢曲松、头孢唑啉的药物耐药率分别为73。17%、57。93%、59。15%，均在50%以上;肺炎克雷伯菌对阿米卡星、厄他培南、美罗培南、哌拉西林/他唑巴坦、替加环素、头孢吡肟、头孢哌酮/舒巴坦、头孢西丁、亚胺培南的药物敏感率分别为 93。88%、97。96%、93。88%、93。88%、95。92%、91。84%、93。88%、93。88%、93。88%，均在 90%以上。血培养G+菌中葡萄球菌属对达托霉素、利福平、利奈唑胺、替加环素、替考拉宁、万古霉素药物敏感率分别为 100。00%、94。37%、100。00%、98。59%、100。00%、100。00%，均在94。37%～100。00%，对苯唑西林、红霉素、青霉素的药物耐药率分别为 64。79%、59。15%、100。00%，均在50%以上;粪肠球菌对红霉素、喹努普汀/达福普汀、四环素的药物耐药率分别为 72。73%、100。00%、63。64%，耐药率均在 50%以上。结论 本院住院人群中BSI患者以G-菌感染居多，不同菌株表现出耐药性差异，临床对症治疗仍需根据BSI患者的菌体培养结果和药敏试验选择合适的抗菌药物治疗。
Distribution and drug resistance of pathogenic bacteria in inpatients with bloodstream infection
Objective To analyze the distribution and drug resistance of pathogenic bacteria in inpatients with bloodstream infection.Methods 129 suspected BSI inpatients were selected as research subjects,and a total of 4688 blood culture samples were sent for testing.Pathogenic bacterial detection and drug sensitivity tests were performed on blood specimens of patients,and the detection,distribution,and drug resistance of pathogenic bacteria were analyzed.Results After removing duplicate strains from the submitted specimens,335 strains of pathogenic bacteria were detected,with a positive rate of 7.15%(335/4688).Pathogenic bacteria were mostly Gram-negative(G-)bacteria,with Escherichia coli,Klebsiella pneumoniae,and Staphylococcus aureus accounting for 48.96%,14.63%,and 10.75%,respectively.A total of 253 strains of G-bacteria and 82 strains of Gram-positive(G+)bacteria were detected.In G-bacteria,the susceptibility rates of Escherichia coli to amikacin,meropenem,piperacillin/tazobactam,tigecycline,ticacillin/clavulanate,cefoperazone/sulbactam and imipenem were 96.34%,100.00%,96.34%,100.00%,90.24%,92.07%and 100.00%,respectively,which were all at 90%above,and the drug resistance rates to ampicillin,ceftriaxone,and cefazolin were 73.17%,57.93%,and 59.15%,respectively,all above 50%.The susceptibility rates of Klebsiella pneumoniae to amicacin,ertapenem,meropenem,piperacillin/tazobactam,tigecycline,cefepime,cefoperazone/sulbactam,cefoxitin and imipenem were 93.88%,97.96%,93.88%,93.88%,95.92%,91.84%,93.88%,93.88%and 93.88%,respectively,both above 90%.In G+ bacteria,the susceptibility rates of staphylococcus to daptomycin,rifampicin,linezolid,tigecycline,teicoplanin and vancomycin were 100.00%,94.37%,100.00%,98.59%,100.00%,100.00%,all in the range of 94.37%-100.00%,respectively.The drug resistance rates for oxacillin,erythromycin and penicillin were 64.79%,59.15%and 100.00%,respectively,all above 50%.The drug resistance rates of Enterococcus faecalis to erythromycin,quinupristin/dalfopristin and tetracycline were 72.73%,100.00%and 63.64%,respectively,all above 50%.Conclusion In our hospital,the majority of bloodstream infection patients are infected with G-bacteria,and different strains exhibit varying degrees of drug resistance.Clinical treatment still needs to be based on the culture results and drug sensitivity tests of the bloodstream infection bacteria to select appropriate antibacterial drugs.

Bloodstream infectionPathogenic bacteriaDrug resistanceDrug sensitivity analysisInpatients

邱忠英

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353000 南平市第一医院

血流感染 致病菌 耐药性 药敏分析 住院人群

2024

10.14164/j.cnki.cn11-5581/r.2024.07.015

中国现代药物应用
中国水利电力医学科学技术学会

中国现代药物应用

影响因子：0.862
ISSN：1673-9523
年,卷(期)：2024.18(7)
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