海南医学院学报2018，Vol.24Issue(5)：577-580,4.DOI:10.13210/j.cnki.jhmu.20180305.001
4142份血培养病原菌分布及其耐药性分析
Distribution and drug resistance of pathogens isolated from 4142 blood cultures
摘要
Abstract
Objective:To investigate the distribution and drug resistance of pathogens isolated from 4 142 blood cul-tures,and provide a scientific foundation for guiding clinical rational use of antimicrobial agents for bloodstream infections. Methods:Blood cultures obtained from 4 142 inpatients and outpatients who were hospitalized from January 2015 to December 2016.The culture was detected by automatic BACT/ALERT 3D blood culture system of biomerieux.Bacteria isolated from positive blood cultures were further identified,and the drug susceptibility tests were conducted by VITEK-2 Compact automat-ic microbial analysis system and ATB Expression microbial analysis system.The drug susceptibility results were evaluated ac-cording to CLSI 2014 standard.Statistical analysis was performed by using WHONET 5.6 software.Results:A total of 396 u-nique strains were isolated from 4 142 blood cultures,and the positive rate is 9.6%.Among the positive blood cultures,194 (49.0%)strains were identified as Gram-positive,185(46.7%)strains were identified as Gram-negative,and 17(4.3%)strains were identified as fungi.The coagulase-negative Staphylococcus were the most frequently detectable(29.2%),followed by Escherichia coli(18.4%),Klebsiella pneumoniae(7.3%),Staphylococcus aureus(5.1%),Acinetobacter baumannii(5.1%), and Enterococcus genera(5.1%).The incidences of methicillin resistant coagulase negative staphylococcus(MRCNS)and me-thicillin resistant staphylococcus aureus(MRSA)were 81.9% and 50.0% respectively.However,vancomycin resistant staphy-lococcus and enterococcus were not detected.The prevalence of extended spectrum β lactamases(ESBLs)in E.coli and K.pneu-moniae were 56.2% and 37.9%,respectively.All the E.coli strains were sensitive to amikacin,piperacillin/tazobactam,imi-penem and meropenem,and the sensitive rate of K.pneumoniae strains to imipenem and meropenem were 93.1% and 89.7%, respectively.Conclusions:MRCNS stains were the most frequently detected pathogens in blood cultures in the present study. The characteristic of drug resistance for the pathogens indicated that monitoring of imipenem and meropenem resistant K. pneumoniae should be underlined to prevent nosocomial outbreak.Fungi bloodstream infections of ward such as ICU and de-partment of hemopathology should be enhanced monitored.关键词
血培养/病原菌分布/耐药性/抗菌药物Key words
Blood culture/Distribution/Drug resistant/Antibacterial分类
医药卫生引用本文复制引用
宁兴旺,姜思宇,朱惠斌,谢小兵,程宇..4142份血培养病原菌分布及其耐药性分析[J].海南医学院学报,2018,24(5):577-580,4.基金项目
湖南省教育厅科学研究项目(17B195) （17B195）
This study was supported by Scientific Research Project of Hunan Provincial Ministry of Education(Grant No.17B195). （Grant No.17B195）
