血管内导管相关性血流感染的病原菌分布及耐药性分析

Distribution of pathogens causing catheter-related bloodstream infections in vascular and drug resistance

目的了解血管内导管相关血流感染(CRBSI)的病原菌分布及其药敏率,为更好地预防和早期治疗CRB-SI提供帮助。方法对医院确诊的68例CRBSI采取回顾性分析,统计病原菌的分布情况及药物敏感试验结果。结果 196例患者中68例为CRBSI的确诊病例,占34.7%,主要来源于ICU、内科病房和老年病房;病原菌分离率前3位依次为鲍氏不动杆菌、表皮葡萄球菌和白色假丝酵母菌,分别占20.6%、17.7%和11.9%;鲍氏不动杆菌等革兰阴性杆菌对头孢哌酮/舒巴坦的耐药率最低,均<50.0%;表皮葡萄球菌等凝固酶阴性葡萄球菌对万古霉素、利奈唑胺敏感率达100.0%;假丝酵母菌属对两性霉素B、5-氟胞嘧啶的敏感率达100.0%。结论了解CRBSI的常见病原菌分布和药敏率有助于临床对CRBSI的预防和早期经验性用药。

OBJECTIVE To analyze the distribution of the pathogens and antimicrobial resistance of catheter-related bloodstream infection（CRBSI）,and provide doctors with the laboratory evidence of CRBSI prevention and earlytreatment.METHODS A retrospective analysis of CRBSI pathogens′ distributions and antimicrobial resistance from 68 inpatients who were diagnosed of CRBSI.RESULTS There were 68（34.7%） patients diagnosed as CRBSI and were from intensive care unit（48）,medicine（12） and the old patients ward（8）.The top 3 by rank order of the CRBSI pathogens were Staphylococcus epidermidis（17.7%）,Acinetobacter baumannii（20.6%） and Candida albicans（11.9%）,respectively.The isolated Gram-positive cocci were resistant to penicillin G,oxacillin and cefazolin,but susceptible to vancomycin and linezolid.Of the isolated Gram-negative bacilli,below 50.0% were resistant to cefperazone/sulbactam.The candida were 100.0% susceptible to amphotericin B and 5-lucytosin.The susceptibility rates to vacomycin and linezolid of coagulase-negative Staphylococcus such as S.epidermidis arrived at 100.0%.CONCLUSIONS To get a better understanding about distribution of CRBSI pathogens and drug susceptibility will be helpful for its prevention and antimicrobial treatment as early as possible.