山东省泰安地区血培养分离病原菌分布及耐药性变迁

Distribution of the Pathogens Bacteria Isolated from Blood Cultures and Changes in Drug Resistance in Tai'an Shandong Province

目的探讨泰安地区血培养病原菌的分布及耐药性变迁,为治疗临床血流感染的合理用药提供依据。方法回顾性分析青岛大学附属泰安市中心医院2015—2021年血培养阳性的数据,使用WHONET 5.6软件进行药敏结果的统计分析。结果7年间血培养标本中共分离病原菌5349株,其中革兰阴性菌占61.4%(3284/5349),革兰阳性菌占35.3%(1886/5349),真菌占3.3%(179/5349)。革兰阴性菌中大肠埃希菌(27.5%,1470/5349)、肺炎克雷伯菌(11.3%,607/5349)、铜绿假单胞菌(2.6%,140/5349)和鲍曼不动杆菌(2.4%,131/5349)分离率最高。革兰阳性菌以表皮葡萄球菌(5.7%,306/5349)和金黄色葡萄球菌(3.9%,211/5349)为主。大肠埃希菌对酶抑制剂和碳青霉烯类药物敏感率均大于90%,肺炎克雷伯菌对亚胺培南和美罗培南的平均耐药率分别为9.2%和9.5%。铜绿假单胞菌对大多数抗菌药物均保持较高的敏感性。鲍曼不动杆菌除对替加环素敏感外,对多种抗菌药物敏感率均低于30%。未发现对万古霉素、替考拉宁和利奈唑胺耐药的葡萄球菌。结论该院血培养病原菌以革兰阴性菌为主。加强血流感染病原菌的耐药监测,对于指导临床合理使用抗菌药物,遏制耐药菌株的暴发流行具有重要意义。

Objective To analyze the distribution and drug resistance changes of pathogens from blood cultures in our hospital from 2015 to 2021,it is important to provide a basis for clinical treatment of bloodstream infections.Methods Respectively analysis of positive blood cultures between 2015 and 2021,and the results of drug sensitivity were analyzed by WHONET 5.6 software.Results A total of 5349 strains of pathogens were isolated in blood cultures during the past seven years,including 3284 strains(61.4%)of Gram-negative bacteria,1886 strains(35.3%)of Grampositive bacteria,and 179 strains(3.3%)of fungi.The most common gram-negative bacteria were Escherichia coli(27.5%,1470/5349),Klebsiella pneumoniae(11.3%,607/5349),Pseudomonas aeruginosa(2.6%,140/5349)and Acinetobacter baumanii(2.4%,131/5349).Gram-positive bacteria were mainly Staphylococcus epidermidis(5.7%,306/5349),followed by Staphylococcus aureus(3.9%,211/5349).Escherichia coli was sensitive to enzyme inhibitors and carbapenem.Klebsiella pneumoniae had an average resistance rate of 9.2%and 9.5%to imipenem and meropenem,respectively.Most drugs caused extreme sensitivity in Pseudomonas aeruginosa.Acinetobacter baumanii was completely sensitive to tigecycline and the sensitivity rate to most antibiotics was lower than 30%.There were no Staphylococcus strains resistant to vancomycin,teicoplanin and linezolid.Conclusions Gram-negative bacteria were the main pathogens in blood cultures in our hospital.It is important to strengthen the surveillance of drug resistance of pathogens in bloodstream infection and to guide the rational use of antibiotics in clinics for controlling the outbreak of drug-resistant strains.