某院2017年-2019年2836株临床常见血流感染病原菌的分布及常见病原菌的耐药性分析

Analysis on Distribution of 2836 Strains of Bloodstream Infection Pathogens and Drug Resistance of Main Pathogenic Bacteria in a Hospital from 2017 to 2019

目的:分析医院常见血流感染病原菌的分布及常见病原菌的耐药特点,为防控感染提供指导意见。方法:选取医院2017年1月—2019年12月收治的血流感染血培养阳性标本患者2 400例病历资料,分析其常见病原菌的分布及其耐药特点。结果:2 400例血培养阳性标本患者中,分离出病原菌2 836株,其中革兰阴性菌1507株(占53.14%)、革兰阳性菌1 108株(占39.07%)、真菌134株(占4.72%)和厌氧菌87株(占3.07%);革兰阳性菌中人葡萄球菌人亚种占10.23%,革兰阴性菌中大肠埃希菌占21.93%;2 836株病原菌中各年度的分布分别为2017年占29.80%、2018年占40.40%和2019年占29.80%;药敏结果发现,人葡萄球菌人亚种对苯唑西林的耐药率为最高(达91.03%),大肠埃希菌对氨苄西林的耐药率为最高(达75.08%)。结论:血流感染病患者感染病原菌以革兰阴性菌感染为主,其中革兰阳性菌中人葡萄球菌亚种和革兰阴性菌中大肠埃希菌对多种药物的耐药率均较高,临床应加强病原菌的监控,针对主要病原菌应根据药敏结果合理使用抗菌药物治疗,以确保其临床疗效。

Objective: to analyze the distribution of 2 836 strains of bloodstream infection pathogens and drug resistance of main pathogenic bacteria in in a hospital from 2017 to 2019, and to provide guidance for prevention and control of the infection. Methods: The medical records of 2 400 patients with blood culture positive samples of bloodstream infection admitted to our hospital from January 2017 to December 2019 were selected to analyze the distribution of common pathogenic bacteria and the characteristics of drug resistance. Results: In 2 400 patients with positive blood culture samples, 2 836 strains of pathogenic bacteria were isolated, of which 53.14% were Gram-negative bacteria,39.07% were Gram-positive bacteria, 4.72% were fungi and 87 were anaerobic bacteria(3.07%). Subspecies of Staphylococcus Homi in Gram-positive bacteria accounted for 10.23%, and Escherichia coli in Gram-negative bacteria accounted for 21.93%. The annual distribution of 2 836 pathogenic strains was 29.80% in 2017, 40.40% in 2018 and29.80% in 2019. The results showed that the resistance of human subspecies of Staphylococcus hominis to oxacillin was the highest(up to 91.03%), and the resistance of Escherichia coli to ampicillin was the highest(up to 75.08%). Conclusion: Bloodstream infections disease pathogen of infection with Gram-negative bacteria infection is given priority to, including gram-positive bacteria in Staphylococcus subspecies and gram negative bacteria Escherichia coli,in the prevalence of multi-drug resistance were higher, clinical pathogen monitoring should be strengthened, and the main pathogenic bacteria should rationally use antibacterial drugs based on the results of the drug susceptibility, to ensure its clinical efficacy.