摘要
目的了解2017年鄞州地区血流感染病原菌分布及耐药性,为临床诊疗提供依据。方法收集2017年1月-12月临床送检的血培养标本,采用全自动血培养仪进行病原菌培养,另用全自动细菌鉴定仪进行鉴定和药敏实验。结果 11 450份血培养标本共检出病原菌526株(4.6%),其中革兰阳性菌264株(50.2%),以凝固酶阴性葡萄球菌为主;革兰阴性菌248株(47.1%),以大肠埃希菌为主;真菌14株(2.7%),以白假丝酵母为主。病原菌检出率以普外科最高。革兰阳性球菌对利奈唑胺、万古霉素、替加环素未检出耐药菌;大肠埃希菌未检出阿米卡星耐药株;肺炎克雷伯菌除对氨苄西林、哌拉西林外,耐药率均较低;铜绿假单胞菌对青霉素类、头孢菌素类和磺胺类抗生素几乎都耐药。结论本地区血流感染以革兰阳性球菌为主,且耐药情况普遍;故了解病原菌的科室分布及耐药性的变迁对控制感染有重要意义。
Objective In this study, we want to analyze distribution characteristics and antibiotic resistance of bloodstream infection bacteria at Yinzhou in 2017, so as to provide basis for clinical diagnosis and treatment. Methods A total of 11 450 blood samples were collected from January to December in 2017. The pathogens were cultured by automatic blood culture instrument. The bacterial identification and drug sensitivity test were carried out by automatic bacterial identification instrument. Results A total of 526 pathogenic bacteria strains were detected in 11 450 blood culture specimens, with a positive rate of 4.6%. Among the strains, 264 strains(50.2%) were Gram-positive bacteria strains, Coagulase negative cocci was the main pathogen, 248 strains(47.1%) were Gram-negative bacteria strains, E.coli was the main pathogen, and 14 strains(2.7%) were Fungi, Candida albicans was the main Fungi. The detection of pathogenic bacteria was the highest in general surgery department. Gram-positive bacteria were highly sensitive to linezolid, vancomycin and tigcycline, and no drug-resistant bacteria were detected. Amikacin resistant strains were not detected in E.coli. Klebsiella pneumoniae had lower antibiotic resistance rates except to Ampicillin and Piperacillin. Pseudomonas aeruginosa was resistant to Penicillins, Cephalosporins and Sulfonamides. Conclusion Gram-positive cocci were dominant in bloodstream infection at Yinzhou, and the antibiotic resistance was common. Therefore, it is very important to figure out the pathogenic bacteria distribution in bloodstream and the antibiotic resistance changes. Furthermore, this study can contribute to the infection control at Yinzhou.
引文
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