神经重症病房血管内导管相关性血流感染的病原菌分布及耐药分析

Pathogenic bacterial distribution and drug resistance analysis of intravascular catheter-related bloodstream infection in neurointensive care unit

目的 分析神经重症病房(NCU)血管内导管相关性血流感染的病原菌分布及耐药性,为临床合理控制感染提供依据。方法 采用WHONET5.6软件对2020年1月至2021年12月NCU分离的血管内导管相关性血流感染患者的病原菌进行分析。结果 在送检的253份样本中,78例导管相关性血流感染患者共检出病原菌85株,其中革兰阳性菌占38.82%,革兰阴性菌占55.29%,真菌占5.89%;革兰阳性菌对替加环素、万古霉素的耐药率均为0,对大环内酯类、氨基糖苷类、喹诺酮和四环素类抗生素的耐药率均在90%以上,对青霉素和苯唑西林全部耐药;革兰阴性菌中肠杆菌科对头孢曲松、哌拉西林、复方新诺明和环丙沙星的耐药率均在90%以上,非发酵菌中的鲍曼不动杆菌为广泛耐药。结论 了解NCU血管内导管相关性血流感染病原菌分布及耐药性,有助于指导NCU血管内导管相关性血流感染的治疗。

Objective To analyze the pathogenic bacterial distribution and drug resistance of intravascular catheter-related bloodstream infection(CRBSI) in neurointensive care unit(NCU) to provide a basis for rationally controlling infection in clinic.Methods The WHONET 5.6 software was used to analyze the pathogenic bacteria isolated from NCU in the patients with CRBSI from January 2020 to December 2021.Results Among 253 submitted samples, 85 strains of pathogenic bacteria were detected in 78 cases of CRBSI,in which Gram-positive bacteria accounted for 38.82%,Gram negative bacteria accounted for 55.29% and fungi accounted for 5.89%;the resistant rates of Gram-positive bacteria to tigecycline and vancomycin was all 0,the resistant rates to macrolides, aminoglycosides, quinolones and tetracyline antibiotics was more than 90% and all were resistant to penicillin G and oxacillin;the drug resistance rates of enterobacteriaceae in Gram-negative bacteria to ceftriaxone, piperacillin, cotrimoxazole and ciprofloxacin were above 90%,and acinetobacter baumannii in non-fermentative bacteria was extensively drug resistant.Conclusion Understanding the pathogenic bacterial distribution and drug resistance of CRBSI in NCU is helpful to guide the treatment of CRBSI in NCU.