重症监护病房相关血流感染的病菌分布以及耐药特性分析

Analysis of distribution and drug resistance of pathogens related to bloodstream infection in intensive care unit

目的分析重症监护病房相关血流感染的病菌分布以及耐药特性。方法选取本院重症监护病房因留置导管引发的相关血流感染者98例,对其血液标本行细菌鉴定和药敏试验,分析其病菌分布及耐药性特点。结果 98例患者共分离出病原菌108株,其中革兰阳性菌45株,革兰阴性菌58株,真菌5株。革兰阳性菌以表皮葡萄球菌、金黄色葡萄球菌及溶血葡萄球菌为主,革兰阴性菌以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌为主;主要革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、阿米卡星等具有较高的敏感性,耐药率较低,而鲍曼不动杆菌的耐药性菌均处于较高的水平,而肺炎克雷伯菌耐药性较低;主要革兰阳性菌对万古霉素、利奈唑胺、替加环素等敏感性较高,而青霉素G的耐药性普遍较高。结论革兰阴性菌是重症监护病房因留置导管引发的相关血流感染患者的主要病原菌,且根据药敏试验结果用药,可减少耐药性产生。

Objective To analyze the distribution and drug resistance of pathogens in bloodstream infection in intensive care unit.Methods A total of 98 patients with bloodstream infection caused by indwelling catheter in our hospital in intensive care unit were selected.The blood samples applied drug susceptibility test and bacterial identification to analyze the distribution and drug resistance of the bacteria.Results A total of 108 strains of pathogens in 98 patients were isolated,among which 45 strains were Gram-positive bacteria,58 were Gram-negative bacteria,5 were fungi.Gram-positive bacteria were mainly Staphylococcus epidermidis,Staphylococcus aureus,and Saphylococcus haemolyticus,and Gram-negative bacteria were mainly Escherichia coli,Pseudomonas aeruginosa and Klebsiella pneumoniae.Major Gram-negative bacteria have a higher sensitivity to imipenem,cefoperazone/sulbactam,piperacillin/tazobactam,amikacin,and lower resistance rates,while Bowman acinetobacter resistance to bacteria were at a high level,while Klebsiella pneumoniae had lower resistance rate.The main gram-positive bacteria had higher sensitivity on vancomycin,linezolid,tigecycline,and penicillin G resistance was generally higher.Conclusion Gram-negative bacteria are the main pathogens of patients with bloodstream infection caused by indwelling catheter and drugs usage according to drug sensitivity test results can reduce drug resistance.