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1. 西南医科大学基础医学院
2. 成都医学院第一附属医院
纸质出版日期:2020,
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[1]石娇,王光西,丁曼琳,周英顺.2014~2018年某三甲医院血流感染分布及革兰阴性菌耐药性分析[J].西南医科大学学报,2020,43(02):118-123.
SHI Jiao, WANG Guang xi, DING Man lin, et al. Distribution of bloodstream infection and drug resistance of Gram-negative bacteria in a grade A tertiary hospital from 2014 to 2018[J]. Journal of Southwest Medical University, 2020,43(2):118-123.
[1]石娇,王光西,丁曼琳,周英顺.2014~2018年某三甲医院血流感染分布及革兰阴性菌耐药性分析[J].西南医科大学学报,2020,43(02):118-123. DOI:
SHI Jiao, WANG Guang xi, DING Man lin, et al. Distribution of bloodstream infection and drug resistance of Gram-negative bacteria in a grade A tertiary hospital from 2014 to 2018[J]. Journal of Southwest Medical University, 2020,43(2):118-123. DOI:
目的:分析本院血流感染常见革兰阴性菌分布、耐药性及碳青霉烯酶基因型
为临床血流感染的防治提供依据。方法:选择2014年1月至2018年12月临床送检血培养标本及其分离革兰阴性菌为研究对象
梅里埃ATB及药敏系统对细菌种属进行鉴定和药敏测定
PCR检测碳青霉烯酶基因型。结果:在所送检13 028例血培养标本中
1 283份标本为血培养阳性。并从中分离到革兰阴性菌
阳性菌和真菌分离率分别为58.07%(n=745)
39.59%(n=508)和2.34%(n=30)。所分离细菌主要由大肠埃希菌61.07%(n=480)
肺炎克雷伯菌18.19%(n=143)
阴沟肠杆菌4.71%(n=37)
铜绿假单胞菌3.69%(n=29)和鲍曼不动杆菌2.42%(n=19)等组成。所分离菌细菌对青霉素类、头孢菌素类、氨基糖苷类、氟喹诺酮类、复方新诺明、头孢菌素/酶抑制剂、碳青霉烯类耐药率分别为85.44~100.00%
12.78~55.60%
0.00~38.30%
6.10~47.40%
13.57~96.00%
18.41~100.00%和0.00~100.00%。产碳青霉烯酶基因主要有bla
KPC
bla
NDM
bla
IMP
和bla
OXA-23
且存在同时携带bla
KPC
和bla
NDM
菌株。结论:血流感染革兰阴性菌对常见抗菌药物耐药性严峻
应加强此类菌临床监测
指导临床合理用药。
Objective: To analyze the distribution
drug resistance
and carbapenemase genotypes of commonGram-negative bacteria in bloodstream infection in our hospital
and to provide evidence for prevention and treat-ment of clinical bloodstream infection. Methods: We selected blood culture specimens examined between January2014 and December 2018
and took the isolated Gram-negative bacteria to identify the species and drug susceptibil-ity by the Mérieux ATB and antibiotic susceptibility testing system and determine the carbapenemase genotypes byPCR. Results: Among 13 028 blood culture samples examined
1 283 samples were positive
and Gram-negativebacteria
Gram-positive bacteria
and fungi were found in 58.07%(n = 745)
39.59%(n = 508)
and 2.34%(n =30) of the samples
respectively. The isolated bacteria mainly included Escherichia coli(61.07%
n = 480)
Klebsi-ella pneumoniae(18.19%
n = 143)
Enterobacter cloacae(4.71%
n = 37)
Pseudomonas aeruginosa(3.69%
n =29)
and Acinetobacter baumannii(2.42%
n = 19). The resistance rates of the isolated bacteria to penicillins
ceph-alosporins
aminoglycosides
fluoroquinolones
sulfamethoxazole/trimethoprim
cephalosporins/enzyme inhibitors
and carbapenems were 85.44 ~ 100.00%
12.78 ~ 55.60%
0.00 ~ 8.30%
6.10 ~ 47.40%
13.57 ~ 96.00%
18.41 ~ 100.00%
and 0.00 ~ 100.00%
respectively. The carbapenemase-producing genes mainly included bla
KPC
bla
NDM
bla
IMP
and bla
OXA-23
and there were strains carrying both bla
KPC
and bla
NDM
. Conclusion:Gram-negative bacteria in bloodstream infection are severely resistant to common antibiotics. Clinical monitoring ofthe bacteria should be strengthened to guide rational drug use in clinical practice.
血流感染革兰阴性菌抗菌药物耐药情况分析
Bloodstream infectionGram-negative bacteriaAntibioticsDrug resistance analysis
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