1 490株血液标本分离细菌分布及其耐药性
Distribution and drug resistance of 1 490 strains of bacteria isolated from blood samples
刘超梅 1李方舒 1周璐坤 1王振楠 1赵建平 2郭素芳3
作者信息
- 1. 联勤保障部队第969医院检验病理输血科,内蒙古呼和浩特 010051
- 2. 内蒙古自治区人民医院检验科,内蒙古呼和浩特 010010
- 3. 内蒙古医科大学附属医院检验科,内蒙古呼和浩特 010010
- 折叠
摘要
目的 分析医院血培养分离菌的构成及耐药性,为临床血流感染的诊治提供参考.方法 回顾性分析联勤保障部队第969医院2020年1月-2022年12月临床送检标本血培养阳性结果,参考美国临床和实验室标准化协会(CLSI)相应年份标准对药敏结果进行判读.结果 共分离细菌1 490株,革兰阳性菌756株(50.74％)、革兰阴性菌734株(49.26％);革兰阳性菌以凝固酶阴性葡萄球菌、屎肠球菌、金黄色葡萄球菌及粪肠球菌为主;革兰阴性菌以大肠埃希菌、马耳他布鲁菌、肺炎克雷伯菌及铜绿假单胞菌为主;儿童与成人血培养分离菌株的构成存在一定差异;耐甲氧西林金黄色葡萄球菌(MRSA)检出率低于耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)(P＜0.05),葡萄球菌对替加环素、万古霉素及利奈唑胺100.00％敏感;屎肠球菌对万古霉素的耐药率为1.92％;大肠埃希菌产超广谱β-内酰胺酶(ESBLs)株检出率高于肺炎克雷伯菌产ESBLs株(P＜0.05);肺炎克雷伯菌对亚胺培南、美罗培南耐药率分别为11.61％、12.50％;铜绿假单胞菌对大多数抗菌药物耐药率＜15％.结论 血培养分离细菌种类较多,且耐药形势严重,应加强血流感染病原学监测,为临床合理用药提供依据.
Abstract
OBJECTIVE To analyze the distribution and drug resistance of pathogens isolated from blood culture in the hospital,and to provide reference for the diagnosis and treatment of clinical bloodstream infections.METHODS A retrospective analysis was conducted on the positive blood culture results of clinical samples sent to the Joint Lo-gistic Support Force 969th Hospital from Jan 2020 to Dec 2022,and the drug sensitivity test results were interpre-ted according to the corresponding year standards of the American clinical laboratory standards institute(CLSI).RESULTS A total of 1 490 bacterial strains were isolated from blood samples,including 756 gram-positive bacteria(50.74％)and 734 gram-negative bacteria(49.26％).The main gram-positive bacteria were coagulase negative Staphylococcus,Staphylococcus aureus,Enterococcus faecium,and Enterococcus faecalis.Escherichia coli,Klebsiella pneumoniae,Brucella Malta,and Pseudomonas aeruginosa were the most common gram-negative bacteria.There were certain differences in the composition of bacteria in blood culture between the children and the adults.The detection rate of methicillin-resistant S.aureus(MRSA)was lower than that of methicillin-resistant coagulase negative S.aureus(MRCNS)(P＜0.05).Staphylococcus was 100.00％sensitive to tigecycline,vanco-mycin,and linezolid.The drug resistance rates of faecium was 1.92％.The detection rate of E.coli strains produ-cing broad-spectrum bacteria β-lactamase(ESBLs)was significantly higher than that of K.pneumoniae strains producing ESBLs(P＜0.05).The drug-resistant rates of K.pneumoniae to imipenem and meropenem were 11.61％and 12.50％,respectively,and that of P.aeruginosa to most antibiotics were all＜15％.CONCLUSION There are many types of strains isolated from blood culture,which shows the severe situation of drug resistance.It is necessary to strengthen the pathogen monitoring of bloodstream infections and provide a basis for rational drug use in clinical practice.
关键词
血培养/血流感染/细菌/不同年龄组/抗菌药物/耐药性Key words
Blood culture/Bloodstream infection/Bacteria/Different age groups/Antibiotic/Drug resistance引用本文复制引用
基金项目
内蒙古自治区卫生计生科研计划(201702004)
出版年
2024
NETL
NSTL
万方数据