2018年宁夏某院血培养病原菌分布与报警时间分析

Analysis of the distribution and alarm time of pathogenic bacteria in blood culture in a hospital in Ningxia in 2018

目的了解血培养病原菌的分布与报警时间的关系,及时指导临床医生准确合理选择抗菌药物。方法采用回顾性调查方法,对宁夏医科大学总医院2018年1-12月门诊及住院患者的1161株血培养阳性菌株的分布和报警时间进行分析。结果1161株血培养阳性菌株中革兰阴性菌563株(48.49%),革兰阳性菌223株(19.21%),厌氧菌55株(4.74%),真菌23株(1.98%),污染菌297株(25.58%)。位列前5位的菌种分别为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、布鲁菌及屎肠球菌。血培养阳性主要分布在急诊科、重症监护病房、感染疾病科、儿科和肿瘤科。主要检出菌中<18 h阳性报警的有586株,检出率为50.5%;18~24 h阳性报警的有159株,检出率为13.7%;>24~48 h阳性报警的有247株,检出率为21.3%;>48 h阳性报警的有169株,检出率为14.6%。297株污染菌中89.5%的阳性报警时间≥18 h。结论宁夏医科大学总医院菌种分布有明显的区域特点,布鲁菌为主要血流感染菌。病原菌阳性报警时间短,污染菌株阳性报警时间绝大多数≥18 h。

Objective To understand the relationship between the distribution of pathogenic bacteria in blood culture and the alarm time,so as to provide guidance for reasonable clinical use of antibiotics.Methods A retrospective investigation method was used to analyze the distribution and alarm time of 1161 blood culture-positive strains in outpatients and inpatients from January to December 2018 in the General Hospital of Ningxia Medical University.Results Among 1161 blood culture positive strains,563 strains(48.49%)of gram-negative bacteria,223 strains(19.21%)of gram-positive bacteria,55 strains(4.74%)of anaerobic bacteria,and 23 strains(1.98%)of fungi,there were 297 strains(25.58%)of contaminating bacteria.The top 5 bacterial species were Escherichia coli,Klebsiella pneumoniae,Staphylococcus aureus,Brucella and Enterococcus faecium.Positive blood cultures were mainly distributed in the emergency department,intensive care unit,infectious diseases department,pediatrics department and oncology department.Among the main detected bacteria,there were 586 strains with a positive alarm for<18 h(50.5%),159 strains with a positive alarm for 18-24 hours(13.7%),and 247 with a positive alarm for>24-48 hours(21.3%),169 strains were positive for>48 h(14.6%).The 89.5%of the 297 contaminated bacteria had a positive alarm time of≥18 h.Conclusion The distribution of bacteria in the General Hospital of Ningxia Medical University has obvious regional characteristics.Brucella is the main bloodstream infection.Pathogens report positive alarm time for a short period of time,and most polluted strains report positive alarm time≥18 h.