摘要
目的分析广东某医院血培养阳性培养物病原菌分布及耐药性分析,从而为临床合理应用抗生素提供依据。方法回顾性分析广东某医院2019年859份血培养阳性的标本,经BACT/ALERT 3D(Bio Mérieux)全自动血培养仪对由配套培养瓶采集的标本进行培养,培养阳性标本将进一步经VITEK 2 Compact(Bio Mérieux)全自动微生物鉴定仪进行鉴定和药敏检测,部分菌株药敏采用K-B法,应用EXCEL 2019和SPSS 25.0软件对数据进行分析。结果859份血培养阳性标本主要来自感染科、重症医学科和新生儿科;获得临床分离株872株,病原菌种数78种,革兰氏阴性菌株占60.09%,革兰氏阳性菌株占37.73%,真菌占1.72%;主要菌株为大肠埃希菌(36.81%)、凝固酶阴性葡萄球菌(12.96%)、肺炎克雷伯菌(12.61%)、金黄色葡萄球菌(8.83%);其中肠杆菌科细菌对头孢美唑(CMZ)、多粘菌素E(PE)、莫西沙星(MFX)、多利培南(DRO)、替加环素(TGC)敏感率达100%,对青霉素类药物(阿莫西林、哌拉西林)均耐药,MRCNS和MRSA的病原菌检出率分别为74.44%、40.00%。葡萄球菌属对利奈唑胺(LNZ)、万古霉素(VAN)、替加环素(TGC)和替考拉宁(TEC)均敏感。结论血流感染的病原菌菌种多样,其检出率因科室不同而不同,其耐药率因科室和菌种的差异可有明显差异。掌握相应医院或地区病原菌分布及其耐药率变化尤为重要,可指导临床抗生素的合理使用,进而降低血流感染病死率和耐药菌的产生。
Objective To investigate the distribution and drug resistance of pathogens in blood culture positive culture of a hospital in Guangdong retrospectively so as to provide basis for rational use of antibiotics in clinic.Methods A total of 859 blood culture positive samples from a hospital in Guangdong in 2019 were retrospectively analyzed.The samples collected from matching culture bottles were cultured by BACT/ALERT 3D(Bio Mérieux)automatic blood culture instrument.The positive samples were further identified and tested by VITEK 2 Compact(Bio Mérieux)automatic microbiological identification instrument.The drug sensitivity of some strains was determined by Kraft B method.EXCEL 2019.SPSS 25.0 software were used to analyze the data.Results All of the 859 blood culture positive samples were collected from the departments of infection,intensive care medicine and neonatal pediatrics.872 clinical isolates were obtained,including 78 sorts of pathogenic bacteria with 60.09%of gram-negative strains,37.73%of gram-positive strains and 1.72%of fungi.The main strains were Escherichia coli(36.81%),coagulase negative staphylococci(12.96%),Klebsiella pneumoniae(12.61%)and Staphylococcus aureus(8.83%).Enterobacteriaceae bacteria were sensitive to cefmetazole(CMZ),polymyxin E(PE),moxifloxacin(MFX),Doripenem(DRO)and tegacycline(TGC),and were resistant to penicillin(amoxicillin and piperacillin).The detection rates of pathogens in MRCNS and MRSA were 74.44%and 40.00%,respectively.Staphylococci were sensitive to linezolid(LNZ),vancomycin(VAN),tegacycline(TGC)and teicoplanin(TEC).Conclusion There are many kinds of pathogenic bacteria in bloodstream infection,and the detection rate varies from department to department,and the drug resistance rate varies significantly with the difference of departments and strains.It is particularly important to understand the distribution of pathogens and the changes of drug resistance rate in corresponding hospitals or regions,which can guide the rational use of clinical antibiotics and reduce the mortality of blood stream infection and the production of drug-resistant bacteria.
作者
尹小毛
梁碧霞
邱玖香
王治伟
YIN Xiaomao;LIANG Bixia;QIU Jiuxiang;WANG Zhiwei(Shunde Hospital,Guangzhou Medical University,Foshan 528315,China;不详)
出处
《现代医院》
2021年第8期1283-1286,共4页
Modern Hospitals
基金
广东省自然科学基金项目(2017A030310019)。
关键词
血培养
抗生素
血流感染
耐药率
菌株
敏感性
Blood culture
Antibiotic
Bloodstream infection
Drug resistance rate
Strain
Sensitivity
