某三甲医院5年间血流感染细菌分布及耐药性分析

Distribution and Drug Resistance Analysis of Bloodstream Infection Bacteria in a Tertiary Hospital in 5 Years

摘要: 目的：基于某医院抗菌药物耐药监测，确定血流感染常见的致病菌分离株及其抗菌药物敏感性特征。方法：使用来自广安某三甲医院5年间抗菌药物药敏试验记录进行横断面回顾性研究，对纳入统计的1031株细菌药敏结果进行分析。结果：革兰阴性菌占55.1%，革兰阳性菌占44.9%，革兰阴性菌以大肠埃希菌和克雷伯菌属为主；革兰阳性菌主要为葡萄球菌属。药敏结果显示MRSA和MRSCNS的检出率为31.1%和75.5%，葡萄球菌属中鉴定出2株万古霉素耐药株，尚未发现利奈唑胺和替加环素耐药株；过去5年监测显示，产酶(ESBLs)株大肠埃希菌对部分抗菌药物敏感率呈下降趋势；凝固酶阴性葡萄球菌对克林霉素敏感率上升；大肠埃希菌对阿莫西林/克拉维酸敏感率上升。结论：临床分离血流感染菌株对常见抗菌药物呈水平趋势，但如产酶株大肠埃希菌对头孢吡肟、环丙沙星及氨曲南敏感率下降，提示该院需要加强抗菌药物管理，遏制耐药。

Abstract: Objective: Based on a hospital antibiotic resistance surveillance, identify Bloodstream infection-pathogenic strains and their antibiotic sensitivity characteristics. Methods: A cross-sectional retro-spective study was conducted using the records of antimicrobial susceptibility testing of a tertiary hospital in Guang’an for 5 years, and the antimicrobial susceptibility results of 1031 bacterial strains included in the statistics were analyzed. Results: Gram-negative bacteria: 55.1%, gram- pos-itive bacterium: 44.9%, gram-negative bacteria mainly bacteria E. coli and K. pneumonia; the gram-positive bacteria were mainly staphylococcus. The detection rates of methicillin-resistant S. aureus (MRSA) and methicillin-resistant coagulase-negative staphylococci (MRCNS) were 31.1% and 75.5%. There were 2 vancomycin resistant strains and no linezolid and tigacycline resistant strains in Staphylococcus. The susceptibility rates of Extended-spectrum β-lactamase (ESBLs)-producing E. coli to some antibiotics showed a decreasing trend; The sensitivity of coagulase negative staphylo-coccus to clindamycin increased. The susceptibility of E. coli to amoxicillin/clavulanic acid increased. Conclusion: There was no change in the susceptibility of bloodstream infection strains to common antibiotics, but the sensitivity of producing ESBLs E. coli cefepime, ciprofloxacin and aztreonam de-creased, suggesting that the hospital needs to strengthen the management of antibiotics to curb drug resistance.