滁州市某医院血流感染病原菌分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria in blood-stream infection in a hospital of Chuzhou City

目的了解2022年滁州市某医院血培养中的主要病原菌分布及其耐药性,为临床合理使用抗菌药物提供参考。方法回顾性对2022年滁州市某医院送检血培养标本分离的病原菌鉴定和药物敏感试验,应用WHONET 5.6软件对药物敏感试验结果进行分析。结果送检血培养标本5017份,分离出不重复病原菌165株,检出阳性率为3.29%,其中革兰阳性菌68株占41.21%、革兰阴性菌95株占57.58%、真菌2株占1.21%;分离菌中前5位菌株为大肠埃希菌占23.64%、人葡萄球菌占16.97%、肺炎克雷伯菌占11.52%、金黄葡萄球菌占11.52%、奇异变形杆菌占7.27%。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)、耐甲氧西林金黄色葡萄球菌(MRSA)分别占凝固酶阴性葡萄球菌(CNS)和金黄色葡萄球菌(SAU)67.50%和36.84%,葡萄球菌对万古霉素、替考拉宁、达托霉素、利奈唑胺和替加环素均100%敏感;大肠埃希菌和肺炎克雷伯菌中超广谱β-内酰胺酶(ESBLs)的检出率分别为30.77%和0,大肠埃希菌对亚胺培南和厄他培南敏感度达100.00%,肺炎克雷伯菌对亚胺培南和厄他培南耐药率均为10.53%,奇异变形杆菌对亚胺培南和厄他培南耐药率分别为33.33%和0。结论滁州市某医院血流感染病原菌以革兰阴性菌为主,分离菌对常用抗菌药物耐药情况不同,应加强对血流感染的病原菌耐药性监测,帮助临床医生根据药敏结果合理选择抗菌药物,及时有效控制血流感染。

Objective To analyze the distribution and drug resistance of main pathogenic bacteria in the blood culture of a hospital in Chuzhou City in 2022,providing a reference for the rational use of antibacterial drugs in clinical practice.Methods The pathogen identification and drug sensitivity test of blood culture samples isolated from a hospital in Chuzhou City in 2022 were analyzed retrospectively by WHONET 5.6 software.Results A retrospective study was conducted on 5017 blood culture samples submitted for examination,and 165 strains of non-repetitive pathogenic bacteria were isolated,with a positive rate of 3.29%.Among them,68 strains of gram-positive bacteria accounted for 41.21%,95 strains of gram-negative bacteria accounted for 57.58%,and 2 strains of fungi accounted for 1.21%.The top 5 isolates were Escherichia coli accounting for 23.64%,Staphylococcus hominis accounting for 16.97%,Klebsiella pneumoniae accounting for 11.52%,Staphylococcus aureus accounting for 11.52%and Proteus mirabilis accounting for 7.27%.Methicillin-resistant coagulase-negative Staphylococcus(MRCNS)and methicillin-resistant Staphylococcus aureus(MRSA)accounted for 67.50%and 36.84%of coagulase-negative Staphylococcus(CNS)and Staphylococcus aureus(SAU),respectively.Staphylococcus is 100%sensitive to vancomycin,teicoplanin,daptomycin,linezolid,and tigecycline.The detection rates of extended-spectrum lactamases(ESBLs)in Escherichia coli and Klebsiella pneumoniae were 30.77%and 0.The sensitivity of Escherichia coli to imipenem and ertapenem was 100.00%,the resistance rate of Klebsiella pneumoniae to imipenem and ertapenem was 10.53%,and the resistance rates of Proteus mirabilis to imipenem and ertapenem were 33.33%and 0.Conclusion The main pathogenic bacteria for bloodstream infections in a hospital in Chuzhou City are Gram-negative bacteria,and the resistance of isolated bacteria to commonly used antibacterial drugs is different.It is necessary to strengthen the monitoring of drug resistance of pathogenic bacteria in bloodstream infection and help clinicians rationally select antibiotics according to the results of drug sensitivity,to control bloodstream infection timely and effectively.