Positive report time, distribution and antimicrobial resistance of pathogens from blood culture at a maternity and child health care hospital

Abstract:

ObjectiveTo analyze the positive report time, distribution and antimicrobial resistance of pathogens isolated from blood culture at a hospital, so as to provide laboratory basis for prevention, contro1,and  rational antimicrobial use for bloodstream infection.MethodsFrom January 2013 to January 2015, blood culture specimens of outpatients and inpatients were performed bacterial identification and antimicrobial susceptibility testing, antimicrobial resistance was analyzed.ResultsA total of 1 973 blood culture specimens were sent by clinical departments, 219 (11.10%) of which were isolated pathogens. Most positive blood culture specimens were from department of paediatrics(n=199).  Isolation rates of gramnegative bacteria, grampositive bacteria, and fungi were  44.34% (n=98), 50.23%  (n=111)，and 5.43% (n=12) respectively; the main pathogens was  coagulasenegative staphylococcus (n=53, 23.98%), followed by Escherichia coli (n=39,17.65%), Staphylococcus aureus (n=23, 10.41%), Klebsiella pneumoniae (n=15, 6.79%)，and Pseudomonas aeruginosa (n=13,5.88%), the average positive blood culture  report time of top five pathogens was 1-2 days. The detection rates of extendedspectrum βlactamaseproducing Escherichia coli and Klebsiella pneumoniae accounted for 53.85% and 53.33% respectively, susceptibility of gramnegative bacilli to carbapenems was relatively high（76.92%-100%）; methicillinresistant isolates accounted for 39.13% among Staphylococcus aureus and  64.15% among coagulasenegative staphylococcus, vancomycinresistant  and teicoplaninresistant strains were not found;  resistant rate of Candida glabrata to 5fluorocytosine was 14.29%，but was susceptible to amphotericin B.ConclusionThe major pathogens isolated blood culture are grampositive bacteria,  in order to reduce the emergence of drugresistant strains, clinicians should choose antimicrobial agents according to blood culture results and antimicrobial susceptibility testing results.