某医院重症医学科患者血流感染病原菌分布及耐药性分析的研究

Distribution and drug resistance analysis of pathogenic bacteria in intensive care unit bloodstream infection in a hospital

目的 分析2013-2022年该院重症医学科(ICU)血流感染感染病原菌分布和对抗菌药物的耐药性。方法 收集2013-2022年ICU血流感染患者的临床菌株数据,使用WHONET5.6软件和SPSS13.0软件统计分析。结果 2013-2022年分离出307株病原菌,革兰阴性菌有185株(60.3%),其中大肠埃希菌93株(30.3%),肺炎克雷伯菌48株(15.6%),铜绿假单胞菌10株(3.3%),鲍曼不动杆菌9株(2.9%);革兰阳性菌有93株(30.3%),其中葡萄球菌属49株(16.0%),肠球菌属31株(10.1%);真菌有29株(9.4%),以白念珠菌和光滑念珠菌为主。大肠埃希菌和肺炎克雷菌对碳青霉烯类耐药率分别为2.2%和22.9%,对第3代头孢菌素耐药率为60.2%和45.8%;铜绿假单胞菌和鲍曼不动杆菌对碳青霉烯类耐药率分别为20.0%和88.9%;革兰阳性菌主要对万古霉素、替加环素和利奈唑胺的敏感率高,对青霉素和红霉素的耐药率较高。结论 该院ICU血流感染患者的主要致病菌是革兰阴性菌,耐药菌检出率较高。临床科室应加强致病菌的耐药监测,合理规范使用抗菌药物。

Objective To analyze the distribution and drug resistance of pathogens causing bloodstream infection in intensive care unit(ICU)of the hospital from 2013 to 2022.Methods The clinical strain data of patients with bloodstream infection in ICU from 2013 to 2022 were collected and analyzed by WHONET 5.6 software and SPSS13.0 software.Results A total of 307 pathogenic bacteria were isolated from 2013 to 2022.Among them,185 strains(60.3%)of Gram-negative bacteria,including 93 strains(30.3%)of Escherichia coli,48 strains(15.6%)of Klebsiella pneumoniae,10 strains(3.3%)of Pseudomonas aeruginosa and 9 strains(2.9%)of Acinetobacter baumannii.There were 93 strains(30.3%)of Gram-positive bacteria,including 49 strains(16.0%)of Staphylococcus and 31 strains(10.1%)of Enterococcus.There were 29 strains(9.4%)of fungi,mainly Candida albicans and Candida glabrata.The drug resistance rates of Escherichia coli and Klebsiella pneumoniae to carbapenems were 2.2%and 22.9%,and to the third generation cephalosporins were 60.2%and 45.8%.The drug resistance rates of Pseudomonas aeruginosa and Acinetobacter baumannii to carbapenems were 20.0%and 88.9%.Gram-positive bacteria were mainly sensitive to vancomycin,tigecycline and linezolid,and resistant to penicillin and erythromycin.Conclusion Gram-negative bacteria are the main pathogens of bloodstream infection in ICU patients in the hospital,and the detection rate of drug-resistant bacteria is relatively high.Clinical departments should strengthen the monitoring of drug resistance of pathogenic bacteria and rationally standardize the use of antibiotics.