血流感染成年患者的致病菌与药物敏感性研究

Study on Pathogenic Bacteria and Drug Sensitivity in Adult Patients with Blood Flow Infection

目的:研究血流感染成年患者的致病菌以及药物敏感性情况,为临床治疗提供依据。方法:分析在2015年1月-2016年12月本院各科室送检的临床患者血培养标本3 140例,阳性菌株359例,采用美国BD Phoenix^(TM)-100全自动鉴定药敏系统进行药物敏感性检测。结果:3 140例患者的血液标本中分离出病原菌359株,检出阳性率为11.43%。革兰阴性杆菌264株,占比73.54%;革兰阳性球菌91株,占比25.35%;真菌4例,占比1.11%。大肠埃希菌、阴沟肠杆菌对碳青霉烯类药物的耐药率为0;肺炎克雷白菌对碳青霉烯类药物的耐药率为3.57%。在金黄色葡萄球菌中耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为21.43%,凝固酶阴性葡萄球菌(CNS)中耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率为71.43%。结论:血液感染成年患者的致病菌主要为革兰阴性杆菌为主,其中以大肠埃希菌和阴沟肠杆菌为主,对哌拉西林/他唑巴坦、阿米卡星及头孢他啶的耐药率较低;耐甲氧西林葡萄球菌对大环内酯类、青霉素类、氨基糖苷类、红霉素、克林霉素、喹诺酮类、复方磺胺的耐药率均较高,应引起临床研究的关注和重视。

Objective:To study pathogenic bacteria and drug susceptibility in adult patients with bloodstream infection,and provide the basis for clinical experience.Method:A total of 3 140 blood samples from clinical departments in our hospital from January 2015 to December 2016 were selected,and discovered 359 positive samples,they were collected for drug susceptibility testing using the American BD PhoenixTM-100 automatic identification system Detection.Result:A total of 359 pathogenic bacteria were isolated from blood samples of 3 140 patients,the positive rate was 11.43%.Gram-negative Bacilli were 264 strains accounting for 73.54%,Gram-positive Bacteria were 91 strains accounting for 25.35%,Fungi 4 cases accounting for 1.11%.Escherichia Coli,Enterobacter Cloacae drug resistance rate to Carbapenem were 0.Klebsiella Pneumoniae drug resistance rate of Carbapenem was 3.57%.The detection rate of MRSA in Staphylococcus Aureus was 21.43%.The detection rate of MRCNS in CNS was 71.43%.Conclusion:The main pathogens in adult patients with bloodstream infection are Gram-negative Bacilli,Escherichia Coli and Enterobacter Cloacae are the main pathogens,but the drug resistance rate of they are lower to Piperacillin/Tazobactam,Amikacin and Ceftazidime.The drug resistance rate of Methicillin-resistant Staphylococci are higher to Macrolides,Penicillins,Aminoglycosides,Erythromycin,Clindamycin,Quinolones and Sulfamethoxazole,which should arouse the attention and emphasis of clinical research.