三亚某医院血流感染病原菌分布及耐药性

Distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in Sanya city

摘要:

目的了解三亚地区某医院血流感染病原菌分布及其耐药情况。方法回顾性分析该院2013年1月—2015年12月临床送检血培养标本及药敏试验结果。结果3 195份血培养标本共检出阳性病原菌356株，阳性率为11.14%，其中革兰阴性菌215株（占60.39%），革兰阳性菌122株（占34.27%），真菌19株（占5.34%）。革兰阴性菌分离菌株数较多的是大肠埃希菌（90株，25.28%）、肺炎克雷伯菌（60株，16.85%）及假鼻疽伯克霍尔德菌（24株，6.74%）；革兰阳性菌则以金黄色葡萄球菌（42株，11.80%）、凝固酶阴性葡萄球菌（38株，10.67%）及链球菌属细菌（33株，9.27%）居多。大肠埃希菌及肺炎克雷伯菌对头孢哌酮/舒巴坦、阿米卡星及碳青霉烯类耐药率低于10.00% 。假鼻疽伯克霍尔德菌对多数抗菌药物的耐药率低于10.00%。主要革兰阳性菌未检测出耐利奈唑胺及万古霉素的菌株。结论近期该院血流感染病原菌以革兰阴性菌为主，尤其假鼻疽伯克霍尔德菌的分离率较其他地区高，应引起临床重视。

Abstract:

ObjectiveTo understand the distribution and antimicrobial resistance of pathogens isolated from blood culture in a hospital in Sanya city.MethodsBlood culture specimens and antimicrobial susceptibility testing results in this hospital from January 2013 to December 2015 were analyzed retrospectively.ResultsA total of 356 isolates of pathogenic bacteria were isolated from 3 195 blood culture specimens, the positive rate was 11.14%，including 215（60.39%）gramnegative bacterial strains, 122(34.27%) grampositive bacterial strains, and 19(5.34%) fungi strains. The top 3 gramnegative bacteria were Escherichia coli(n=90, 25.28%), Klebsiella pneumoniae(n=60, 16.85%), and Burkholderia pseudomallei(n=24, 6.74%); the most common grampositive bacteria were Staphylococcus aureus(n=42, 11.80%), coagulasenegative staphylococcus(n=38, 10.67%), and Streptococcus spp.(n=33, 9.27%). Resistance rates of Escherichia coli and Klebsiella pneumoniae to cefoperazone/sulbactam，amikacin, and carbapenems were all lower than 10.00%； resistance rates of Burkholderia pseudomallei to most antimicrobial agents were lower than 10.00%. There were no strains of main grampositive bacteria that were found to be resistant to linezolid and vancomycin.ConclusionGramnegative bacteria are the main pathogens causing bloodstream infection in this hospital in recent years, especially the isolation rate of Burkholderia pseudomallei is higher, which should arouse more attention in clinic.