3265例血培养标本的病原菌分布及耐药分析

Analysis of Pathogen Distribution and Drug Resistance in 3265 Blood Culture Samples

目的分析血培养标本病原菌的分布及其对抗菌药物的耐药性,为临床合理选用抗菌药物提供依据。方法收集2021年6月1日—2022年5月31日广东省中西医结合医院住院及门诊送检的3265例血培养标本,分离出的菌株采用质谱仪进行鉴定、自动化仪器法或纸片法进行药敏试验,回顾性分析检出的病原菌的分布特点及药物结果情况。结果3265例血培养标本中分离出病原菌268株,其中革兰阴性菌占54.85%、革兰阳性菌占41.42%、真菌占3.73%;主要菌株为大肠埃希菌、肺炎克雷伯菌、表皮葡萄球菌、金黄色葡萄球菌。分理出的菌株主要来自重症医学科(52例,19.40%),其次是呼吸内科(42例,15.67%)、肿瘤内科(40例,14.93%)。肠杆菌科细菌对碳青霉烯类抗生素高度敏感(敏感率>90.00%)。葡萄球菌对万古霉素、利奈唑胺以及替加环素100%敏感。屎肠球菌耐药率高于粪肠球菌。结论血培养分离的病原菌具有种类广泛、耐药性差异较大的特点,密切关注血标本检出细菌及耐药率变化情况有重要意义,指导临床合理用药,提高治愈率和减少耐药菌的发生。

Objective To analysis the distribution of pathogenic bacteria and their resistance to antibiotics in blood culture samples.so as to provide guidance for reasonable clinical use of antimicrobial agents.Methods A total of 3265 blood culture samples from the inpatient and outpatient in Guangdong Integrated Traditional Chinese and Western Medicine Hospital between June 1,2021 to May 31,2022.The isolated strains were identified by mass spectrometer,and the drug sensitivity test was performed by automated instrument method or paper method.Retrospective analysis of the distribution characteristics of pathogenic bacteria and drug results.Results 268 strains of pathogenic bacteria were isolated from 3265 blood culture samples,of which 54.85%were Gram-negative bacteria,41.42%were Gram-positive bacteria,and 3.73%were Fungi.The main strains were Escherichia coli,Klebsiella pneumoniae,Staphylococcus epidermidis,Staphylococcus aureus and Staphylococcus aureus.The strains separated were mainly from the department of severe medicine(52 cases,19.40%),followed by the department of respiratory medicine(42 cases,15.67%)and the department of oncology(40 cases,14.93%).Enterobacteriaceae bacteria were highly sensitive to carbapenem antibiotics(sensitivity rate>90.00%).Staphylococcus was 100%sensitive to vancomycin,linezolid and tegacyclin.The drug resistance rate of Enterococcus faecalis was higher than that of Enterococcus faecalis.Conclusion Blood culture separation pathogenic bacteria have the characteristics of extensive types and large differences in resistance.It is important to pay close attention to the change of bacteria and drug resistance rates,guide clinical rational drug use,improve the cure rate and reduce the occurrence of drug-resistant bacteria.