2012—2015年医院血流感染病原菌分布及耐药性变迁

Changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in 2012-2015

摘要:

目的了解某院2012—2015年血流感染病原菌分布及耐药性变迁特征。方法收集该院2012年1月—2015年12月检验中心微生物室血培养分离病原菌，分为2012—2013年组和2014—2015年组，比较两组菌株的分布特征、构成情况以及对抗菌药物的敏感性。结果两组时间段内分离的病原菌以革兰阴性菌为主，分别占各组菌株的54.96%和54.66%，两组病原菌分布构成比较，差异无统计学意义（P＞0.05）。革兰阳性球菌对万古霉素和利奈唑胺敏感性高，耐药率均为0；凝固酶阴性葡萄球菌（CNS）对苯唑西林的耐药率均＞80%，对青霉素的耐药性也均＞90%；肠杆菌科细菌对亚胺培南、美罗培南的敏感性高，但已出现耐此类药物菌株；两组时间段鲍曼不动杆菌对米诺环素较为敏感，耐药率分别为35.90%和34.55%，对其他药物耐药率均较高（＞75%）。结论该院血流感染的病原菌耐药菌检出率高，应引起警惕，加强细菌耐药性监测有利于指导临床合理选择和使用抗菌药物。

Abstract:

ObjectiveTo investigate the changes in distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in 2012-2015. MethodsPathogenic bacteria isolated from blood culture in a hospital microbiology laboratory between January 2012 and December 2015 were collected and divided into 2012-2013 group and 2014-2015 group, distribution characteristics, constitute, and antimicrobial susceptibility of two groups were compared. ResultsGramnegative bacteria were the main pathogens isolated during two periods, accounting for 54.96% and 54.66% respectively, there was no significant differences in pathogen distribution between two groups (P>0.05). Grampositive cocci had a high sensitivity to vancomycin and linezolid, resistant rates were both 0; resistance rates of coagulase negative staphylococci to oxacillin were all >80%, resistance to penicillin was also >90%; Enterobacteriaceae was highly sensitive to imipenem and meropenem, but resistance strains had appeared; Acinetobacter baumannii was sensitive to minocycline during two periods, resistance rates were 35.90% and 34.55% respectively, resistance rates to other antimicrobial agents were also high (>75%). ConclusionThe isolation rate of drugresistant pathogenic strains causing bloodstream infection is high, monitoring on bacterial resistance is helpful for guiding rational use of antimicrobial agents in clinic.