摘要
目的了解医院院内血流感染病原菌分布及耐药性,为临床医师选择抗菌药物提供参考。方法参照原卫生部医院感染诊断标准,收集来自南宁市某大学附属医院2014年1月—2017年12月住院患者中所有血培养阳性的院内血流感染病例,对病原菌分布及其药物敏感性进行总结分析。结果共收集到该院院内血流感染1 234例,分离出1 254株病原菌,其中革兰阴性菌检出最多,占51.8%,革兰阳性菌检出占39.9%,真菌检出占5.9%。革兰阴性菌除铜绿假单胞菌对临床常用抗菌药物的敏感率均较高外,大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌对常用抗菌药物的耐药率均超过60%;革兰阳性菌中苯唑西林耐药金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)的发生率分别为46.1%和83.1%,肠球菌对糖肽类较敏感。结论院内血流感染病原菌以革兰阴性菌检出最常见,大部分分离菌株对常用抗菌药物的耐药率较高,临床医师应根据药敏结果合理用药,避免细菌耐药的发生。
Objective To understand the distribution and drug resistance of pathogenic bacteria in nosocomial blood infection and provide reference for clinicians to select antimicrobial agents. Methods All cases of nosocomial blood infection with positive blood culture were collected from a affiliated hospital of a university in Nanning,Guangxi,from January 2014 to December 2017 according to the diagnostic criteria for nosocomial infection issued by the Ministry of Health.The distribution and drug sensitivity of pathogenic bacteria were summarized and analyzed. Results A total of 1 234 cases of nosocomial bloodstream infection were collected and 1 254 strains of pathogenic bacteria were isolated.Of the 1 254,51.8% was Gram-negative bacteria,39.9% was Gram-positive bacteria,5.9% was Fungi.The resistance rates of Escherichia coli,Klebsiella pneumoniae and Acinetobacter baumannii to commonly used antimicrobial agents was over 60%.Pseudomonas aeruginosa was highly sensitive to commonly used antibiotics in clinic.The incidence of oxacillin resistant staphylococcus aureus(MRSA)and oxacillin resistant coagulase-negative staphylococcus(MRCNS)were 46.1% and 83.1%,respectively.Enterococcus was more sensitive to glycopeptides. Conclusion The most common pathogens of nosocomial blood infection are Gram-negative bacteria and most isolates have high resistance to common antimicrobial agents.Clinicians should use drugs reasonably according to drug sensitivity results to avoid the occurrence of bacterial drug resistance.
作者
赖远全
黄春
田玉玲
伍世轰
植丽
LAI Yuanquan;HUANG Chun;TIAN Yuling(Department of General Medicine,Guangxi University of Chinese Medicine,Nanning, 530011,China)
出处
《中国社会医学杂志》
2019年第2期214-217,共4页
Chinese Journal of Social Medicine
基金
广西医疗卫生重点科研课题项目(2010098)
关键词
医院感染
血流感染
病原菌
耐药性
Nosocomial infection
Blood stream infection
Pathogens
Drug-resistance
