2016-2019年某肿瘤医院血培养病原菌分布及耐药性分析

Distribution and Drug Resistance Analysis of Pathogens in Blood Cultures of a Cancer Hospital from 2016 to 2019

目的了解中国科学院大学附属肿瘤医院血培养阳性病原菌的分布及耐药特征,指导临床合理用药。方法回顾性分析2016年1月-2019年12月我院临床血培养阳性的病原菌的构成及药敏结果。结果2016-2019年20789份血培养标本共分离的病原菌为790株,阳性率为3.8%。革兰阴性菌占67.85%,革兰阳细菌占29.11%,真菌占3.04%。前三位的革兰阴性细菌分别是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌;前三位的革兰阳性细菌分别是金黄色葡萄球菌、粪肠球菌、屎肠球菌;真菌主要是白色念珠菌。三种革兰阴性细菌对碳青霉烯类抗生素及大部分酶抑制剂复合抗生素表现为较高的敏感度。三种革兰阳性细菌对万古霉素、替考拉宁均表现为敏感。白色念珠菌对氟康唑和伏立康唑均表现为敏感。结论我院血流感染的病原菌以革兰阴性细菌为主,应根据药敏结果合理使用抗生素,加强细菌耐药的监测,减少耐药菌株的产生。

Objective To investigate the pathogen distribution and antimicrobial resistance of the isolates from blood samples in Cancer Hospital of University of Chinese Academy of Sciences.Methods A retrospective study of the composition and drug susceptibility results from positive clinical blood cultures from January 2016 to December 2019 in our hospital was analyzed.Results A total of 790 strains of pathogens were isolated from20789 specimens of clinical blood cultures,the positive rate was 3.80%.Among them,Gram-negative bacteria accounted for 67.85%,Gram-positive bacteria accounted for 29.11%and fungi accounted for 3.04%respectively.The top three Gram-negative bacteria pathogens were E.coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The top three Gram-positive bacteria were Staphylococcus aureus,Enterococcus faecalis and Enterococcus faecium.The fungus is mainly candida albicans.The three gram-negative bacteria showed high sensitivity to?carbapenem antibiotic and most enzyme inhibition.The three gram-positive bacteria have the best sensitivity to vancomycin and teicolanin.Candida albicans are most sensitive to fluconazole and voriconazole.Conclusion Gram-negative bacteria are the predominant pathogens in bloodstream infection.Antibiotics should be used reasonably according to drug sensitivity results,and the monitoring of bacterial drug resistance should be strengthened to reduce the generation of drug-resistant strains.