【摘要】 目的了解近3年新乡地区血流感染病原菌分布及其对常用抗菌药物耐药性,为临床合理使用抗菌药物提供参考依据。方法回顾分析2014年10月-2017年9月新乡医学院第一附属医院和第二附属医院血流感染病原菌临床分布和耐药状况,分离培养和鉴定按照《全国临床检验操作规程》进行,药敏试验采用纸片扩散法(K-B法)和MIC法,数据采用WHONET5.6软件统计分析。结果 38 016份血培养标本,检出病原菌3 428株,阳性检出率9.0%,其中革兰阴性菌1 689株,占49.3%,革兰阳性菌1 411株,占41.2%,分离率居前5位的细菌依次是凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌和鲍曼不动杆菌。大肠埃希菌、肺炎克雷伯菌对多数抗菌药物耐药率高达50.0%以上,对碳青霉烯类抗生素保持较好的敏感性;鲍曼不动杆菌对常用抗菌药物耐药率菌均高于30.0%;耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)的检出率分别为43.3%和65.7%。结论血流感染病原菌种类多样,耐药情况严重,临床应重视耐药性监测,根据药敏结果合理选用抗菌药物,以减缓耐药菌株的产生和流行,有效控制血流感染。更多还原

【Abstract】 Objective To study the clinical distribution and the drug resistance of pathogens from bloodstream infections(BSI)in the past 3 years in Xinxiang area, and to offer reference basis for the rational use of antibiotics. Methods The clinical distribution and drug resistance of pathogens from BSI from Oct 2014 to Sep 2017 of the First Affiliated Hospital of Xinxiang Medical College and the Second Affiliated Hospital were reviewed and analyzed. The blood culture specimens were processed according to the National clinical laboratory operation procedures, the drug sensitivity tests were conducted by K-B method and MIC method, and the results were analyzed by WHONET 5.6 software. Results 3428 pathogens were isolated from 38016 blood culture specimens, the positive detection rate was 9.02%. Among them, 1689 strains(49.27%) were Gram-negative bacteria,1 411 stains(41.16%) were Gram-positive bacteria. The top 5 pathogens were Coagulase-negative staphylococci(CNS), Escherichia coli, Klebsiella pneumoniae,Staphylococcus aureus and Acinetobacter baumannii. The drug resistance rates of Escherichia coli and Klebsiella pneumoniae were higher than 50%, but carbapenem antibiotics showed good sensitivity. The drug resistance rates of Acinetobacter baumannii were high to the antibiotics. The detection rates of MRSA and MRCNS were 43.3% and 65.7%. Conclusion The pathogens from BSI were various and the drug resistance was serious.It is necessary to strengthen the detection of resistance so as to rational selection of antibiotics, reduce drug-resistant strains and effective control bloodstream infections.更多还原