摘要
目的:研究医院血流感染的病原菌分布及对常用抗菌药物的耐药性,为临床合理使用抗菌药物提供依据。方法:对31144份临床送检的血标本进行细菌培养、鉴定和药敏试验,应用WHONET 5.6对药敏结果进行统计分析。结果:31144份血培养标本中共分离到1653株病原菌,检出率为5.3%。分离得到的1653株病原菌中:革兰阴性菌检出972株(检出率58.8%);革兰阳性菌检出469株(检出率28.4%);真菌检出212株(检出率12.8%)。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌及肺炎克雷伯菌的检出率分别为53.5%及41.1%,耐甲氧西林金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的检出率分别为38.5%及77.2%。革兰阴性菌和革兰阳性菌两者耐药率无显著性差异。大肠埃希菌及肺炎克雷伯菌对碳青霉烯类抗菌药物的耐药率为3.5%~4.9%。未发现耐万古霉素和利奈唑胺葡萄球菌。结论:血流感染病原菌种类多,耐药情况复杂,定期对病原菌分布和耐药情况进行监测,可以指导临床合理使用抗菌药物。
Objective： To study the distribution of pathogenic bacteria in bloodstream infection and their resistance to commonly used antibiotics in our hospital, in order to provide references for clinical rational use of antibiotics. Methods： Bacterial culture, identification and drug susceptibility test were carried out in 31144 clinical samples. The result of susceptibility test was analyzed by WHONET 5.6. Results： A total of 1653 strains of pathogens were isolated from 31144 blood samples, and the detection rate was 5.3%. Among 31144 blood samples, there were 972 gram-negative bacteria（the detection rate： 58.8%）, 469 gram-positive bacteria（the detection rate： 28.4%） as well as 212 fungi（the detection rate： 12.8%）. The detection rates of extended-spectrum β-lactamases（ESBLs） and Escherichia coli and Klebsiella pneumoniae were 53.5% and 41.1%, respectively. The detection rates of methicillin-resistant Staphylococcus aureus（MRSA） and coagulase negative Staphylococcus aureus（MRCNS） were 38.5% and 77.2%, respectively. No significant difference was found between the gramnegative and gram-positive bacteria. The antibiotic resistance rates of Escherichia coli and Klebsiella pneumoniae carbapenems to Carbapenem antibiotics were 3.5%-4.9%. No vancomycin-resistant and linezolid-resistant staphylococcus was found. Conclusion： There were many kinds of pathogenic bacteria in bloodstream infection, and the drug resistance is complex. Therefore, the distribution of pathogens and drug resistance should be monitored periodically to guide clinical rational use of antibiotics.
作者
范蓉
武智聪
杨淑岭
李玉雪
张华俐
李立新
苏喜改
Fan Rong;Wu Zhicong;Yang Shuling;Li Yuxue;Zhang Huali;Li Lixin;Su Xigai(Shijiazhuang First Hospital of Hebei Province, Shijiazhuang 050011, China;Shijiazhuang Fifth Hospital of Hebei Province, Shijiazhuang 050011, China)
出处
《中国药事》
CAS
2018年第6期804-809,共6页
Chinese Pharmaceutical Affairs
关键词
医院感染
病原菌分布
抗菌素耐药性
合理用药
药敏试验
nosocomial infection
bacteria distribution
antibiotics resistance
rational drug use
drugsusceptibility test
