2018—2020年郑州市第七人民医院血流感染分离菌的分布及耐药性分析

目的 了解血流感染分离菌的分布及耐药特征，为临床防治血流感染提供指导和依据。方法 收集2018年1月—2020年12月郑州市第七人民医院血培养分离的非重复菌株，采用WHONET5.6软件统计菌株的分布及耐药特征。结果 共分离546株菌株，革兰阴性菌302株（55.31%），革兰阳性菌220株（40.29%），真菌24株（4.40%）。前6位分离菌依次为凝固酶阴性葡萄球菌（CNS，23.44%）、大肠埃希菌（18.68%）、肺炎克雷伯菌（14.84%）、金黄色葡萄球菌（6.04%）、鲍曼不动杆菌（4.21%）和铜绿假单胞菌（3.85%）。大肠埃希菌对碳青霉烯类最敏感，肺炎克雷菌碳对美罗培南和亚胺培南的耐药率分别为30.86%和35.80%，鲍曼不动杆菌耐药较严重，耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别为72.66%、42.42%，未发现利奈唑胺和万古霉素耐药的葡萄球菌。结论 革兰阴性菌是医院血流感染的主要致病菌，细菌耐药情况复杂，临床要根据药敏结果合理选择抗菌药物。

Distribution and drug resistance analysis of bloodstream infection isolates from Zhengzhou Seventh People's Hospital from 2018 to 2020

Objective To investigate the distribution and drug resistance characteristics of bloodstream infection isolates, to provide guidance and basis for clinical prevention and treatment of bloodstream infection. Methods The non-repeated strains isolated from blood culture in Zhengzhou Seventh People''s Hospital from January 2018 to December 2020 were collected. The distribution and drug resistance characteristics of the strains were analyzed by WHONET5.6 software. Results A total of 546 strains of bacteria were isolated, including 302 strains of gram-negative bacteria (55.31%), 220 strains of gram-positive bacteria (40.29%), and 24 strains of fungi (4.40%). The top six isolates were coagulase-negative CNS (23.44%), Escherichia coli (18.68%), Klebsiella pneumoniae (14.84%), Staphylococcus aureus (6.04%), Acinetobacter baumannii (4.21%), and Pseudomonas aeruginosa (3.85%). Escherichia coli was the most sensitive to carbapenems, and the resistance rates of Kleibacter pneumoniae carbon to meropenem and imipenem were 30.86% and 35.80%, respectively. Acinetobacter baumannii was more resistant, and the detection rates of methicillin-resistant coagulase-negative Staphylococcus and methicillin-resistant golden yellow Staphylococcus aureus were 72.66% and 42.42%, respectively. No Staphylococcus resistant to linezolid and vancomycin were found. Conclusion Gram-negative bacteria are the main pathogens of bloodstream infection in our hospital, and the drug resistance of bacteria is complex. Antimicrobial drugs should be selected reasonably according to drug sensitivity results.