血液感染革兰阴性杆菌266株临床分布及耐药性分析

Analysis of Clinical Distribution and Drug Resistance of 266 Strains of Gram-negative Bacilli Infected in Blood

目的回顾性分析血液感染革兰阴性杆菌临床分离情况及常用抗生素的药敏结果,为临床抗感染治疗和预防多重耐药提供科学依据。方法回顾性分析谷城县人民医院检验科2019年1月至2020年12月血培养阳性的革兰阴性杆菌及药物敏感实验结果。结果血液感染革兰阴性杆菌的分离率不断上升,2019年共分离118株,2020年148株;2019年分离率较高科室依次为内分泌科、肾病内科、神经内科、重症医学科、普外科,2020年依次为肾病内科、神经内科、儿科、肿瘤科、神经外科;细菌分离株数前三位2019年与2020年相同,依次为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌;对CLSI标准中推荐报告的A、B组药物的耐药情况2019年明显高于2020年(p<0.05)。结论血液感染革兰阴性杆菌临床分离率不断上升,常用抗生素的耐药率呈下降趋势。

Objective To retrospectively analyze the clinical isolation of gram-negative bacilli from blood in-fections and the results of drug susceptibility to commonly used antibiotics,so as to provide accurate scientific ba-sis for clinical anti-infective treatment and prevention of multi-drug resistance.Methods To retrospectively ana-lyze the gram-negative bacilli isolated from clinical specimens with positive blood cultures from January 2019 to December 2020 in the Laboratory of Gucheng County People's Hospital.Results The clinical isolation rate of gram-negative bacilli in blood infection is increasing.118 strains were isolated in 2019 and 148 strains were iso-lated in 2020;In 2019,the clinical departments with higher specimen isolation rates were endocrinology depart-ment,nephrology department,neurology department,critical care department and general surgery department,In 2020,the clinical departments with higher specimen isolation rates were nephrology department,neurology de-partment,pediatrics department,oncology department and neurosurgery department;The top three bacterial iso-lates in 2019 as the same as 2020,followed by Escherichia coli,Klebsiella pneumoniae,and Acinetobacter bau-mannii;The drug resistance of group A and group B recommended in CLSI antimicrobial susceptibility test imple-mentation standard in 2019 was significantly higher than that in 2020(P<0.05).Conclusion The isolation rate of clinical specimens of gram-negative bacilli in blood infection is rising,and the drug resistance rate of commonly used clinical antibiotics is showing a downward trend.