| 摘要: |
| 目的:分析天津市南开医院 2018—2021年血流感染患者病原菌构成及耐药变迁情况。方法:收集南开医院 2018年 1月 1日—2021年 12月 31日住院和门诊患者临床血培养标本中分离的非重复病原菌。采用 VITEK2 Compact对其进行鉴定及药敏检测，药敏结果按照 CLSI 2020年版标准判定，数据采用 WHONET 5.6软件进行统计分析。结果:血培养共分离出病原菌 2 383株，其中革兰阴性菌 1 147株，占 48.13%；革兰阳性菌 1 141株，占 47.88%；真菌 95株，占 3.99%。检出率前五位的主要病原菌分别为大肠埃希菌(21.78%)、人葡萄球菌(15.00%)、肺炎克雷伯菌(12.59%)、表皮葡萄球菌(9.74%)和屎肠球菌( 4.97%)。耐碳青霉烯类大肠埃希菌、肺炎克雷伯菌检出率分别为 0.58%和 12.67%。非发酵菌种碳青霉烯类耐药的铜绿假单胞菌( CR-PA)和鲍曼不动杆菌( CR-AB)检出率分别为 52.94%和 60.00%。金黄色葡萄球菌和凝固酶阴性葡萄球菌中甲氧西林耐药株( MRSA和 MRCNS)检出率分别为 26.67%和 72.77%，未发现对万古霉素、替加环素耐药的葡萄球菌属。肠球菌对万古霉素、利奈唑胺和替加环素的耐药率均较低。结论:血流感染以革兰阴性菌为主，但革兰阳性菌有增长趋势，主要分离菌对临床常用抗菌药物耐药率逐年增加，应密切关注血流感染常见菌群的分布及耐药性变迁。 |
| 关键词: 血流感染 病原菌 抗菌药物 耐药性 |
| DOI：10.3969/j.issn.1007-6948.2022.04.017 |
| 投稿时间：2022-01-28 |
| 基金项目: |
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| Distribution and Drug Resistance Change of Pathogens of Bloodstream Infections from 2018 to 2021 in Nankai Hospital |
| XUE Hai-ling，FANG Jie，CHEN Ming-hui |
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| Abstract: |
| Objective To analyze the distribution and drug resistance of pathogens isolated from bloodstream infections from 2018 to 2021. Methods The blood culture samples in Tianjin Nankai Hospital between 2018 and 2021 were collected. The bacterial identification and antimicrobial susceptibility test were carried out by VITEK 2 Compact. The results were interpreted according to CLSI (2020) breakpoints, and the data was analyzed by WHONET 5.6. Results A total of 2 383 strains of pathogenic bacteria were isolated from the blood samples, including 1 147 strains of Gram-negative bacteria (48.13%) , 1 141 strains of Gram-positive bacteria (47.88%) and 95 strains of fungi (3.99%). The top five most frequently isolated pathogens were Escherichia coli (21.78%), Staphylococcus hominis (15.00%), Klebsiella pneumoniae (12.59%), Staphylococcus epidermis (9.74%) and Enterococcus faecium (4.97%). The resistant rates of Escherichia coli and Klebsiella pneumoniae to carbapenems were 0.58% and 12.67% respectively. Among non-fermentative bacteria, Pseudomonas aeruginosa and Acinetobacter baumanni，the resistant rates were 52.94% and 60.00%. The detection rates of methicillin-resistant in Staphylococcus aureus and in coagulase-negative Staphylococcus aureus were 26.67% and 72.77% respectively. The Vancomycin- and tegacycline-resistant Staphylococcus spp.was not found. The resistance of Enterococcus to vancomycin, tegacycline and linezolid were all low. Conclusion The Gram-negative bacteria were most frequently isolated from bloodstream cultures and showed an increasing tendency during the past 4 |
| Key words: Bloodstream infections bacterial pathogens antibiotics drug resistance |
