血流感染病原菌的分布及其耐药性分析

Distribution and Drug Resistance Analysis of Pathogenic Bacteria in Bloodstream Infection

目的:分析永春县医院血流感染常见病原菌的分布特征及耐药性,为临床合理使用抗菌药物并制定其有效的管理方案提供依据。方法:选取永春县医院2020年-2022年期间血培养阳性并确诊为血流感染病例进行回顾性分析,应用美国BectonDickinson公司的BACTECTMFX全自动血液培养仪和M50自动微生物鉴定仪开展菌种鉴定和药敏试验。结果:2020年-2022年共接收送检血培养标本13157份,阳性标本中分离出病原菌株共266株,阳性检出率为2.02%。2022年血培养阳性率与2021年相比较,P<0.05显示差异有统计学意义。阳性标本分离出革兰氏阴性菌166株,占比率为43.77%;革兰氏阳性菌97株,占比率为36.60%。位居前列的细菌是大肠埃希氏菌、肺炎克雷伯氏菌、铜绿假单胞菌及金黄色葡萄球菌。大肠埃希氏菌和肺炎克雷伯氏菌对氨苄西林和头孢唑林的耐药率均>50%;铜绿假单胞菌对吡哌酸、哌拉西林/他唑巴和坦和庆大的耐药率均达到>40%;金黄色葡萄球菌和凝固酶阴性葡萄球菌对氨苄西林和青霉素的耐药率均>90%;未检出对万古霉素耐药菌株。结论:该院血流感染病原菌检出的革兰氏阴性菌占比率最高,其主要病原菌大肠埃希氏菌和肺炎克雷伯氏菌对氨苄西林和头孢唑林的耐药率较高。通过对血流感染病原菌的构成比的统计分析,研究其分布特征及耐药情况,可以为临床早期及时准确的经验性治疗提供理论依据。

Objective:To analyze the distribution characteristics and drug resistance of common pathogenic bacteria in bloodstream infections in Yongchun County Hospital,and to provide a basis for the rational use of antimicrobial drugs in the clinic and the development of its effective management program.Methods:Blood culture-positive cases diagnosed as bloodstream infections in Yongchun County Hospital from 2020 to 2022 were selected for retrospective analysis.Strain identification and drug sensitivity tests were carried out by applying the BACTECTMFX automatic blood culturometer and M50 automatic microbial identifier of Becton Dickinson Company,USA.Results:From 2020 to 2022,a total of 13157 blood culture samples were collected and sent for testing,and a total of 266 pathogenic strains were isolated from the positive samples,with a positive detection rate of 2.02%.The positive rate of blood culture in 2022 was compared with that in 2021,P<0.05,indicating a statistically significant difference.Positive samples isolated 166 Gram-negative bacteria with a ratio of 43.77%and 97 Gram-positive bacteria with a ratio of 36.60%.The top bacteria were Escherichia coli,Klebsiella pneumoniae,Pseudomonas aeruginosa and Staphylococcus aureus.The drug resistance rates of Escherichia coli and Klebsiella pneumoniae to ampicillin and cefazolin were>50%;The drug resistance rates of Pseudomonas aeruginosa to pipemidic acid,piperacillin/tazobactam,and gentamicin reached>40%;The drug resistance rates of Staphylococcus aureus and coagulase-negative staphylococci to ampicillin and penicillin were>90%;And no vancomycin-resistant strains were detected.Conclusion:The highest percentage of Gram-negative bacteria was detected as bloodstream infection pathogens in this hospital,and its main pathogens,Escherichia coli and Klebsiella pneumoniae,had high drug resistance rates to ampicillin and cefazolin.By statistically analyzing the composition ratio of bloodstream infection pathogenic bacteria and studying their distribution characteristics and drug resistance,it can provide a theoretical basis for timely and accurate empirical treatment in the early clinical stage.