上海某三甲医院2014—2021年血流感染病原菌的分布及耐药性分析

Analysis of distribution and antimicrobial resistance of pathogenic bacteria caused by bloodstream infection in a tertiary first-class hospital in Shanghai during 2014 and 2021

本研究对同济大学附属东方医院2014—2021年血培养标本分离的主要病原菌及其耐药性进行统计分析,旨在为临床合理使用抗菌药物提供参考。结果显示,剔除重复菌株后,该院8年间从血培养标本中共检出病原菌1396株,以革兰氏阴性菌为主,占56.3%,其次为革兰氏阳性菌(38.4%)和真菌(5.3%)。居前8位的菌株为大肠埃希菌(21.5%)、凝固酶阴性葡萄球菌(coagulase-negative Staphylococcus,CNS)(17.4%),肺炎克雷伯菌(14.9%)、金黄色葡萄球菌(7.2%)、鲍曼不动杆菌(5.4%)、粪肠球菌(4.2%)、屎肠球菌(3.7%)和铜绿假单胞菌(3.5%)。大肠埃希菌对第3代头孢菌素的8年累积耐药率均超过50%,对碳青霉烯类药物的8年累积耐药率低至1%;肺炎克雷伯菌对碳青霉烯类药物的8年累积耐药率均高于40%;鲍曼不动杆菌对头孢类、氨基糖苷类和碳青霉烯类药物的8年累计耐药率均大于45%。此外,44.6%的金黄色葡萄球菌和74.5%的CNS为耐甲氧西林菌珠。

To provide reference for rational use of antibiotics in clinic,the distribution and antimicrobial resistance of pathogens causing bloodstream infections in Shanghai East Hospital from 2014 to 2021 were statistically analyzed.After removal of duplicate strains,a total of 1396 strains of pathogenic bacteria were detected in blood culture samples during the past eight years.The gram-negative bacteria,gram-positive bacteria and fungi account for 56.3%,38.4%and 5.3%,respectively.The top eight strains were Escherichia coli(21.5%),Coagulase-negative Staphylococcus(CNS)(17.4%),Klebsiella pneumoniae(14.9%),Staphylococcus aureus(7.2%),Acinetobacter baumannii(5.4%),Enterococcus faecalis(4.2%),Enterococcus faecium(3.7%)and Pseudomonas aeruginosa(3.5%).The cumulative resistance rate of Escherichia coli to third-generation cephalosporins in eight years exceeded 50%,and the resistance rate to carbapenems was as low as 1%.The resistance rate of Klebsiella pneumoniae to carbapenems was>40%.The cumulative resistance rates of Acinetobacter baumannii to cephalosporins,aminoglycosides and carbapenems were>45%.In addition,44.6%of Staphylococcus aureus strains and 74.5%CNS stains were methicillin-resistant.