医院获得性血流感染病原菌特征分析

Characteristics of Pathogens in Hospital Acquired Bloodstream Infection

目的分析医院获得性血流感染患者血培养分离病原菌的分布及耐药特点,为临床合理使用抗菌药物提供依据。方法收集2019年6月~2020年5月确诊为医院获得性血流感染患者的血培养结果,使用SPSS20.0分析病原菌种类、科室分布及耐药特点。结果172例医院血流感染患者共分离病原菌193株。病原菌种类:以革兰阴性菌为主,占67.36%,排在前三位的革兰阴性菌分别为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌。科室分布:以肝胆外科、重症监护病房、血液内科为主。主要革兰阴性菌耐药性分析:产ESBLs大肠埃希菌和肺炎克雷伯菌检出率分别为62.79%和8.33%;对碳青霉烯类耐药率以铜绿假单胞菌最高,未检出耐碳青霉烯类大肠埃希菌;对喹诺酮类耐药率以大肠埃希菌最高。结论医院获得性血流感染病原菌以革兰阴性菌为主,对喹诺酮类耐药情况以大肠埃希菌最为严重,建议临床根据药敏结果合理使用抗菌药物,减少耐药菌的产生。

Objective The distribution and drug resistance of pathogens isolated from blood culture of patients with hospital acquired bloodstream infection were analyzed to provide basis for rational use of antibiotics in clinical practice.Methods The blood culture results of patients with hospital acquired bloodstream infection from June 2019 to May 2020 were collected,and the types of pathogens,the distribution of departments and the characteristics of drug resistance were analyzed by using SPSS20.0.Results A total of 193 strains of pathogenic bacteria were isolated from 172 patients with nosocomial bloodstream infection,mainly Gram-negative bacteria(67.36%).The top three Gram-negative bacteria were Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa.The main departments were hepatobiliary surgery,intensive care unit and hematology.The main Gram-negative bacteria resistance analysis showed that the detection rate of ESBLs producing about Escherichia coli and Klebsiella pneumoniae were 62.79%and 8.33%respectively.The highest resistance rate to carbapenem was Pseudomonas aeruginosa.No carbapenem resistant Escherichia coli was detected.The highest resistance rate to quinolones was Escherichia coli.Conclusion Gram-negative bacteria are the main pathogens of hospital acquired bloodstream infection.The resistance of Escherichia coli to quinolones is the most serious.It is suggested that clinical should reasonably use antibiotics according to the drug sensitivity results in order to reduce the production of resistant bacteria.