本文選題：血流感染 + 病原菌��； 參考：《中國(guó)抗生素雜志》2016年10期

【摘要】：目的了解福州地區(qū)血流感染病原菌分布及耐藥狀況,為臨床合理應(yīng)用抗菌藥物提供依據(jù)。方法回顧性分析本醫(yī)院2008年1月—2014年12月臨床送檢的血培養(yǎng)標(biāo)本病原菌構(gòu)成及耐藥性。藥物敏感性試驗(yàn)采用MIC或KB紙片法,按CLSI規(guī)定的標(biāo)準(zhǔn)執(zhí)行;應(yīng)用WHONET5.6軟件分析病原菌的種類及耐藥狀況。結(jié)果 7年間從臨床送檢的血培養(yǎng)標(biāo)本中共培養(yǎng)分離獲得4292株病原菌,其中革蘭陰性菌2667株(占62.14%),革蘭陽(yáng)性菌1353株(占31.52%),真菌272株(占6.34%)。排前三位的病原菌為大腸埃希菌、凝固酶陰性葡萄球菌和肺炎克雷伯菌。主要來(lái)源的科室為血液科、重癥醫(yī)學(xué)科和門診患者。產(chǎn)ESBLs的大腸埃希菌和肺炎克雷伯菌平均檢出率分別為57.46%和24.77%,對(duì)亞胺培南的耐藥率:肺炎克雷伯菌為7.98%并呈上升趨勢(shì),陰溝腸桿菌為9.58%,銅綠假單胞菌為23.66%,鮑曼不動(dòng)桿菌為38.10%。耐甲氧西林凝固酶陰性葡萄球菌(MRCNS)和金黃色葡萄球菌(MRSA)檢出率分別為81.00%和38.60%;未發(fā)現(xiàn)對(duì)萬(wàn)古霉素、利奈唑胺及替加環(huán)素耐藥的葡萄球菌。糞腸球菌和屎腸球菌對(duì)萬(wàn)古霉素的耐藥率分別為0.66%和5.21%。結(jié)論本地區(qū)血流感染病原菌以革蘭陰性菌為主,但應(yīng)重視真菌的感染,針對(duì)性的合理使用抗菌藥物。
[Abstract]:Objective to investigate the distribution and drug resistance of pathogenic bacteria in blood stream infection in Fuzhou, and to provide evidence for rational use of antimicrobial agents. Methods the pathogenic bacteria composition and drug resistance of blood culture samples from January 2008 to December 2014 in our hospital were analyzed retrospectively. The drug sensitivity test was carried out by MIC or KB paper method according to the standard prescribed by CLSI, and the species and drug resistance of pathogens were analyzed by WHONET5.6 software. Results A total of 4292 strains of pathogenic bacteria were isolated from clinical blood culture specimens during the past seven years. Among them, 2667 strains were Gram-negative bacteria (62.14%), 1353 strains were Gram-positive bacteria (31.52%), and 272 strains were fungi (6.34%). The top three pathogens were Escherichia coli, coagulase-negative staphylococcus and Klebsiella pneumoniae. The main sources of departments are hematology, intensive medicine and outpatients. The average detection rates of Escherichia coli and Klebsiella pneumoniae producing ESBLs were 57.46% and 24.77%, respectively. The drug resistance rate of Klebsiella pneumoniae was 7.98% and increased, Enterobacter cloacae 9.58, Pseudomonas aeruginosa 23.66 and Acinetobacter baumannii 38.100.The average detection rate of Escherichia coli and Klebsiella pneumoniae were 57.46% and 24.77%, respectively. The positive rates of methicillin-resistant coagulase-negative staphylococci (MRCNS) and staphylococcus aureus (MRSAs) were 81.00% and 38.60%, respectively, and no vancomycin, linazolamide and tegacycline resistant staphylococci were found. The resistance rates of Enterococcus faecalis and Enterococcus faecium to vancomycin were 0.66% and 5.21%, respectively. Conclusion Gram-negative bacteria are the main pathogens of blood flow infection in this area, but we should pay attention to fungal infection and use antibiotics rationally.
【作者單位】： 福建衛(wèi)生職業(yè)技術(shù)學(xué)院;福建醫(yī)科大學(xué)附屬協(xié)和醫(yī)院;
【基金】：福建省衛(wèi)生廳青年科研資助項(xiàng)目(No.2009-1-20) 福建省教育廳中青年科研項(xiàng)目(No.JB14204)
【分類號(hào)】：R446.5

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