摘要
目的分析广东省江门市五邑中医院2016年1月—2021年12月从患者血培养分离的病原菌及其耐药情况,为血流感染初始治疗及合理使用抗菌药物提供参考依据。方法采用回顾性分析,收集2016年1月—2021年12月江门市五邑中医院患者血培养检出的病原菌及药敏结果,通过WHONET5.6软件进行分析。结果2016年—2021年我院血流感染患者共检出非重复菌株2407株,其中革兰阴性菌1341株(占55.7%),革兰阳性菌944株(占39.2%),6年各病原菌分布差异不大,以革兰阴性杆菌为主,分别为185、211、214、243、228、260株,革兰阳性菌次之,分别为157、165、122、169、165、166株,其中检出率最高的是大肠埃希菌,肺炎克雷伯菌呈逐年上升趋势,金黄色葡萄菌则时高时低。大肠埃希菌碳青霉烯耐药率6年分别为0、0、0、0.7%、0、1.4%。耐碳青霉烯肺炎克雷伯菌检出率上升趋势明显,肺炎克雷伯菌碳青霉烯耐药率2016年为0,2017年为2.6%,2018年为0,2019年为2.6%,2020年为6.5%,2021年为17.0%。非发酵革兰阴性杆菌主要以铜绿假单胞菌和鲍曼不动杆菌为主,铜绿假单胞菌检出数量基本一致,鲍曼不动杆菌数量稍有上升趋势,两者耐药率均有先升后降的情况。6年来血流感染患者检出金黄色葡萄菌分别为41、42、44、38、26、45株,耐甲氧西林金黄色葡萄菌检出率分别为22.0%、26.2%、22.7%、21.1%、30.7%、33.3%。结论血流感染病原菌耐药性呈上升趋势,定期汇总医院血流感染的药敏数据,了解血流感染主要的病原菌及其耐药性,对临床合理用药及时救治患者有重要的意义,对院感部门开展工作,减少耐药菌的产生和传播有很大的帮助。
Objective In order to provide a reference for the initial treatment of bloodstream infections and the sensible use of antibiotics,it is necessary to analyze the pathogenic bacteria isolated from patients'blood cultures and their drug resistance at Wuyi Hospital of Traditional Chinese Medicine,Jiangmen City,Guangdong Province from January 2016 to December 2021.Methods Retrospective analysis was performed to collect the pathogenic bacteria and drug sensitivity results detected by blood culture of patients in Wuyi Hospital of Traditional Chinese Medicine in Jiangmen from January 2016 to December 2021,and the results were analyzed by WHONET5.6 software.Results From 2016 to 2021,a total of 2407 non-duplicate strains were detected in patients with bloodstream infection in our hospital,among them,1341 strains(55.7%)of Gram-negative bacteria,944 strains(39.2%)of Gram-positive bacteria;There was no significant difference in the distribution of pathogens in the six years,and Gram-negative bacilli were predominant,with 185,211,214,243,228 and 260 strains,respectively;The number of Gram-positive strains was 157,165,122,169,165 and 166,respectively;Among them,the highest detection rate is Escherichia coli,Klebsiella pneumoniae showed an increasing trend year by year,and Staphylococcus aureus is high and low.The 6-year carbapenem resistance rates of Escherichia coli were 0,0,0,0.7%,0 and 1.4%,respectively.The detection rate of carbapenem-resistant Klebsiella pneumoniae increased significantly;The carbapenem resistance rates of Klebsiella pneumoniae were 0 in 2016,2.6% in 2017,0 in 2018,2.6% in 2019,6.5% in 2020 and 17.0% in 2021.The nonfermentative Gram-negative bacilli were mainly Pseudomonas aeruginosa and Acinetobacter baumanni,the numbers of each were largely constant while Acinetobacter baumanni's slightly grew.Both strains'rates of treatment resistance increased initially before declining.In the past 6 years,41,42,44,38,26 and 45 strains of S.aureus were detected in patients with bloodstream infection;The detection rates of methicillin-resistant S.aureus were 22.0%,26.2%,22.7%,21.1%,30.7% and 33.3%,respectively.Conclusion The drug resistance of pathogens in bloodstream infection is on the rise;Regularly summarize drug susceptibility data of nosocomial bloodstream infections;Understanding the main pathogens of bloodstream infection and their drug resistance is of great significance for clinical rational drug use and timely treatment of patients;It is of great help to reduce the production and transmission of drug-resistant bacteria to carry out the work on the affected departments of the hospital.
作者
钟一梅
李月桂
谭晓宇
黄晨娟
Zhong Yi-mei;Li Yue-gui;Tan Xiao-yu;Huang Chen-Juan(Department of Clinical Laboratory,Wuyi Hospital of Traditional Chinese Medicine,Jiangmen 529000)
出处
《国外医药（抗生素分册）》
CAS
2023年第4期246-251,共6页
World Notes on Antibiotics
关键词
血流感染
病原菌
耐药性分析
抗菌药物
江门市
耐碳青霉烯的肠杆菌目细菌(CRE)
bloodstream infection
pathogenic bacteri
drug resistance analysis
antibacterial agents
Jiangmen city
carbapenem-resistant enterobacteriales(CRE)
