700株血培养阳性菌的分布及耐药分析

Analysis of distribution and antibiotic resistance of pathogens isolated from 700 strains blood culture

目的分析血培养中分离的病原菌分布及耐药性,为血流感染的经验用药提供依据。方法回顾分析我院血培养分离病原菌的种类及药敏试验结果,采用Whonet 5.6软件进行数据统计分析。结果血培养分离的700株病原菌中,革兰阴性菌412株(58.9%),革兰阳性菌278株(39.7%),真菌10株(1.4%)。耐甲氧西林金黄色葡萄球菌占13.5%(5/37),耐甲氧西林凝固酶阴性葡萄球菌高达68.6%(105/153)。葡萄球菌属对万古霉素、替考拉宁均呈敏感,但2株凝固酶阴性葡萄球菌对利奈唑胺耐药。检出1株耐万古霉素、替考拉宁的屎肠球菌。检出1株耐万古霉素的酪黄/母鸡肠球菌。大肠埃希菌、肺炎克雷伯菌产ESBLs检出率分别为37.1%(65/175)和22.5%(16/71),肠杆菌科细菌对碳青霉烯类抗菌药物最为敏感,敏感率均>99%。结论应实时监测血培养细菌及其耐药性,进而指导抗感染治疗。

Objective To investigate the distribution and antibiotic resistance of pathogens isolated from blood culture so as to provide evidence for clinical treatment to bloodstream infection. Methods A retrospective study of blood cultures in our hospital. The pathogens identification and antibiotic resistance were performed,and the results were statistically analyzed by using WHONET 5. 6 software. Results 700 strains were positive for growth. The frequency of Gram-positive bacteria isolated was 58. 9%（ 412 of 700） and that for Gram-negatives was 39. 7%（ 278 of 700） and that for fungi was 1. 4%（ 10 of 700）. The rates of methicillin resistance in Staphylococcus aureus and coagulase-negative staphylococci（ Co NS） were 13. 5%（ 5/37） and 68. 6%（ 105/153） respectively. Staphylococcus were sensitive to Vancomycin and Teicoplanin,but 2 strains Co NS resistant to Linezolid. There was one strain Excrement enterococcus resistant to Vancomycin and Teicoplanin,one strain cheese yellow/hen enterococcus resistant to Vancomycincus. The detection rates of extended-spectrum β-lactamase（ ESBLs） producing Escherichia coli and Klebsiellapneumoniaewere 37. 1%（ 65/175） and 22. 5%（ 16/71） respectively. Carbapenems were observed to have best sensitivity in Enterobacteriaceae（ more than 99%）. Conclusions It is necessary to monitor blood culture isolates and their antimicrobial resistance patterns for appropriate treatment.