摘要
目的对新疆医科大学附属中医医院住院患者血培养病原菌分布特点及耐药性进行分析,为临床合理使用抗菌药物提供依据。方法回顾性分析2016年1月至2018年12月共1233株住院患者血培养阳性标本分离菌株的资料,对其分布特点、耐药情况等进行研究分析。结果在收集的1233例血培养阳性标本中,以革兰阴性菌为主,其次是革兰阳性菌和真菌。居前5位的是大肠埃希菌,肺炎克雷伯菌,凝固酶阴性葡萄球,金黄色葡萄球菌,屎肠球菌。碳青霉烯类抗菌药物(亚胺培南和美罗培南)对大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌及粘质沙雷菌具有较好的抗菌活性,鲍曼不动杆菌对常用抗菌药物耐药率>60%;葡萄球菌属对红霉素、青霉素高度耐药,未产生对利奈唑胺、替加环素和万古霉素耐药的分离菌株;肠球菌对氨基糖苷类抗菌药物耐药性较高,未发现对利奈唑胺和替加环素耐药的分离菌株。结论临床血培养分离的病原菌以革兰阴性杆菌为主。了解血培养病原菌的分布及耐药性特点,结合药敏试验,帮助临床从经验治疗过渡到目标治疗,是控制血流感染,改善患者预后,降低死亡率的有效措施。
Objective To analyze the distribution and drug resistance of pathogenic bacteria in blood culture of inpatients in the affiliated chinese medical hospital of Xinjiang Medical University. Methods Isolated strains of positive specimens from blood culture in1,233 inpatients from January 2016 to December 2018 were analyzed retrospectively, and their distribution characteristics and drug resistance were analyzed too. Results In 1233 non-repeated pathogenic bacteria, gram-negative bacteria were dominant, followed by gram-positive bacteria and fungi. The top five bacteria were Escherichia coli, Klebsiella pneumoniae, coagulase-negative Staphylococcus,Staphylococcus aureus and Enterococcus faecalis. Imipenem and meropenem had better antimicrobial activity against Escherichia coli,Klebsiella pneumoniae, Pseudomonas aeruginosa and Serratia marcescens. While, the resistance rate of Acinetobacter baumannii to commonly used antimicrobial was higher than 60%. Staphylococcus strains were highly resistant to erythromycin and penicillin.Staphylococcus strains resistant to linezolamine, doxorubicin and vancomycin haven’t been isolated. Enterococcus strains were highly resistant to aminoglycosides antibiotics, and no strains resistant to linezolid and tegamycin were found. Conclusions The pathogenic bacteria isolated from clinical blood culture are mainly gram-negative bacteria. It is an effective measure to understand the distribution of bloodstream pathogens and the resistance of commonly used antimicrobial agents, combined with drug sensitivity test to help clinical transition from empirical treatment to target treatment so as to control the bloodstream infection and improve the prognosis of the patients and reduce the mortality rate.
作者
杨婷
YANG Ting(Department of Clinical Laboratory,the Affiliated Chinese Medical Hospital of Xinjiang Medical University,Urumqi,830000,China)
出处
《新疆医学》
2020年第8期806-809,共4页
Xinjiang Medical Journal
关键词
血培养
血流感染
耐药性
Blood culture
Bloodstream infection
Drug resistance
作者简介
杨婷,女,硕士,初级检验师.研究方向:临床微生物检验。
