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目的了解本院血流感染患者的病原菌种类及耐药特点,为其治疗提供依据。方法收集浙江省人民医院2015年1月-12月门诊及住院患者血培养阳性结果,分析血流感染患者临床资料、病原菌种类及药物敏感性试验资料。结果本研究共统计分析血培养阳性病原菌458株,其中革兰阴性杆菌占56.1%;革兰阳性球菌占42.4%;真菌占1.5%。病原菌分离率居首位的是凝固酶阴性葡萄球菌,占31.0%,其次为大肠埃希菌(19.7%)、肺炎克雷伯菌(16.8%)、鲍曼不动杆菌(5.8%)。耐甲氧西林的金黄色葡萄球菌(MRSA)和凝固酶阴性葡萄球菌(MRCNS)分离率分别为55.0%和54.6%。产超广谱β-内酰胺酶大肠埃希菌和肺炎克雷伯菌检出率分别为46.7%和27.3%。血流感染的鲍曼不动杆菌对亚胺培南耐药率为40.7%,对替加环素耐药率为11.1%。铜绿假单胞菌对亚胺培南耐药率为33.3%,对氨基糖苷类药物具有高敏感性。结论本院血流感染病原菌以革兰阴性杆菌为主。了解血流感染患者病原菌分布及耐药特点,有助于临床抗菌药物经验性应用。
Objective To understand the pathogen types and drug resistance of patients with bloodstream infection in our hospital and provide the basis for its treatment. Methods The positive results of blood culture in outpatients and inpatients from January 2015 to December 2015 in Zhejiang Provincial People’s Hospital were collected. The clinical data, pathogens and drug susceptibility test data of patients with bloodstream infection were analyzed. Results A total of 458 blood-positive pathogens were detected in this study. Among them, Gram-negative bacilli accounted for 56.1%, Gram-positive cocci accounted for 42.4% and fungi accounted for 1.5%. The most common pathogens were coagulase-negative Staphylococcus aureus (31.0%), followed by Escherichia coli (19.7%), Klebsiella pneumoniae (16.8%) and Acinetobacter baumannii (5.8%). The isolation rates of methicillin-resistant Staphylococcus aureus (MRSA) and coagulase-negative staphylococcus (MRCNS) were 55.0% and 54.6%, respectively. The detection rates of extended-spectrum β-lactamase-producing Escherichia coli and Klebsiella pneumoniae were 46.7% and 27.3% respectively. Acinetobacter baumannii infection rate of imipenem was 40.7%, and the rate of resistance to tigecycline was 11.1%. Pseudomonas aeruginosa resistance to imipenem was 33.3%, high sensitivity to aminoglycosides. Conclusion The main pathogens of bloodstream infection in our hospital are Gram-negative bacilli. To understand the distribution of pathogens in patients with bloodstream infections and drug resistance characteristics, contribute to the clinical application of antimicrobial agents.