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襄陽市中醫(yī)醫(yī)院血流感染病原菌的分布與耐藥性分析

發(fā)布時間:2017-12-28 16:34

  本文關(guān)鍵詞:襄陽市中醫(yī)醫(yī)院血流感染病原菌的分布與耐藥性分析 出處:《中國感染與化療雜志》2016年01期  論文類型:期刊論文


  更多相關(guān)文章: 血培養(yǎng) 病原菌 耐藥性


【摘要】:目的了解醫(yī)院血流感染病原菌的分布和耐藥狀況,為臨床治療血流感染提供依據(jù)。方法收集襄陽市中醫(yī)醫(yī)院2014年1—12月門診及住院血流感染患者血培養(yǎng)分離的病原菌及藥敏試驗資料進(jìn)行回顧性分析。結(jié)果血培養(yǎng)共分離病原菌637株,其中以革蘭陽性球菌為主,占55.4%;革蘭陰性桿菌占44.1%;真菌占0.5%。病原菌檢出率排在首位的是凝固酶陰性葡萄球菌,占34.9%;其次為大腸埃希菌,占14.4%;肺炎克雷伯菌,占9.9%;腸球菌屬,占9.9%;金黃色葡萄球菌(金葡菌),占8.3%;鮑曼不動桿菌,占7.4%等。血培養(yǎng)葡萄球菌屬細(xì)菌對青霉素高度耐藥,對紅霉素、克林霉素耐藥率相對較高,對利福平的耐藥率相對較低,尚未發(fā)現(xiàn)耐萬古霉素、替考拉寧、利奈唑胺的菌株。腸球菌屬中屎腸球菌的耐藥率明顯高于糞腸球菌。甲氧西林耐藥金葡菌(MRSA)和凝固酶陰性葡萄球菌(MRCNS)的檢出率分別為47.2%和59.0%。大腸埃希菌和肺炎克雷伯菌對第一、二代頭孢菌素耐藥率較高,對阿米卡星耐藥率較低。產(chǎn)超廣譜β內(nèi)酰胺酶大腸埃希菌和肺炎克雷伯菌檢出率分別為50.0%和36.5%。血流感染中鮑曼不動桿菌對亞胺培南的耐藥率為51.1%,對米諾環(huán)素耐藥率為29.7%;銅綠假單胞菌檢出比例相對較小,對哌拉西林耐藥率較高,對其他抗菌藥物耐藥率相對較低。結(jié)論血培養(yǎng)以革蘭陽性球菌為主。應(yīng)加強對醫(yī)院血培養(yǎng)病原菌進(jìn)行耐藥監(jiān)測,掌握其耐藥特點,合理使用抗菌藥物,防止耐藥菌的傳播。
[Abstract]:Objective to understand the distribution and drug resistance of pathogenic bacteria of blood flow infection in hospital, and to provide the basis for clinical treatment of blood flow infection. Methods the pathogenic bacteria and drug sensitivity test data of blood culture isolated from outpatients and inpatients in Xiangyang Hospital of traditional Chinese medicine from 1 to December 2014 were collected and analyzed retrospectively. Results 637 strains of pathogenic bacteria were isolated from blood culture, of which gram-positive coccus was mainly gram-positive coccus, accounting for 55.4%, gram-negative bacilli accounted for 44.1%, and fungi accounted for 0.5%. The highest incidence of pathogens was coagulase negative staphylococci (34.9%), followed by Escherichia coli (14.4%), Klebsiella pneumoniae (9.9%), Enterococcus (9.9%), Staphylococcus aureus (Jin Pujun), 8.3%, Acinetobacter baumannii (7.4%), and so on. Staphylococcus aureus is highly resistant to penicillin. The resistance rate to erythromycin and clindamycin is relatively high, and the resistance rate to rifampicin is relatively low. No vancomycin, teicoplanin or linezolid resistant strains have been found. The resistance rate of Enterococcus in Enterococcus is significantly higher than that of Enterococcus faecalis. The detection rates of methoxicillin resistant Staphylococcus aureus (MRSA) and coagulase negative staphylococcus (MRCNS) were 47.2% and 59% respectively. The resistance rate of Escherichia coli and Klebsiella pneumoniae to the first, second generation cephalosporins was higher, and the resistance rate to Amikacin was low. The detection rates of Escherichia coli and Klebsiella pneumoniae produced by broad-spectrum beta lactamases were 50% and 36.5% respectively. In the bloodstream infection, the resistance rate of imipenem to Bauman's Acinetobacter was 51.1%, the resistance rate to minocycline was 29.7%, the proportion of Pseudomonas aeruginosa was relatively small, the resistance rate to piperacillin was high, and the resistance rate to other antibiotics was relatively low. Conclusion the main gram positive cocci are in the blood culture. It should be strengthened to monitor the drug resistance of pathogenic bacteria in hospital blood, grasp the characteristics of drug resistance, use antibiotics reasonably, and prevent the spread of drug-resistant bacteria.
【作者單位】: 湖北中醫(yī)藥大學(xué)附屬襄陽市中醫(yī)醫(yī)院檢驗科;
【分類號】:R446.5
【正文快照】: 血流感染是臨床常見嚴(yán)重感染性疾病,起病急、病死率高。為了解我院血流感染病原菌的臨床分布及耐藥情況。本研究對2014年1—12月門診及住院患者血培養(yǎng)分離的637株病原菌進(jìn)行了回顧性分析,F(xiàn)將結(jié)果報道如下。1材料與方法1.1材料1.1.1菌株來源收自本院2014年1—12月門診和住院

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