摘要
目的分析老年住院患者血培养病原菌检出情况及主要病原菌对抗菌药物的耐药性。方法回顾性分析2018年1月—2021年12月某院送检血培养标本中年龄≥60岁的老年住院患者临床资料、病原菌分布及药敏结果。结果共送检血培养标本8138份,阳性标本1067份,血培养阳性率为13.11%。共检出病原菌1097株,其中革兰阴性菌837株,占76.30%;居前三位病原菌分别为大肠埃希菌、肺炎克雷伯菌和金黄色葡萄球菌,分别占41.84%、15.41%、3.83%。血培养病原菌以重症监护病房(ICU)检出数最多(214株,占19.51%)。大肠埃希菌和肺炎克雷伯菌对哌拉西林/他唑巴坦、头孢哌酮/舒巴坦、碳青霉烯类、阿米卡星和替加环素耐药率分别为3.80%和8.59%、4.24%和7.32%、<1%和<6%、2.46%和4.27%、0和1.85%。耐甲氧西林金黄色葡萄球菌(MRSA)检出率为21.95%,未检出对米诺环素、万古霉素、替考拉宁和利奈唑胺耐药的金黄色葡萄球菌。结论老年患者血培养阳性率较高,病原菌以革兰阴性菌为主,其中以大肠埃希菌和肺炎克雷伯菌居多。病原菌对抗菌药物耐药情况不同,应及时送检血培养,根据药敏结果合理使用抗菌药物。
Objective To analyze pathogens detected in blood culture of elderly inpatients in a hospital and antimicrobial resistance of main pathogens.Methods Clinical data,pathogenic distribution and antimicrobial susceptibility testing results of elderly inpatients aged≥60 whose specimens were performed blood culture in a hospital from Ja-nuary 2018 to December 2021 were retrospectively analyzed.Results A total of 8138 blood culture specimens were detected,out of which 1067 were positive,with blood culture positive rate of 13.11%.A total of 1097 pathogenic strains were detected,including 837 Gram-negative bacterial strains,accounting for 76.30%.The top three detected pathogens were Escherichia coli,Klebsiella pneumoniae and Staphylococcus aureus,accounting for 41.84%,15.41%and 3.83%,respectively.The most detected pathogens in blood culture were from intensive care unit(214,19.51%).Resistance rates of Escherichia coli and Klebsiella pneumoniae to piperacillin/tazobactam,ce-foperazone/sulbactam,carbapenems,amikacin and tegacyclin were 3.80%and 8.59%,4.24%and 7.32%,<1%and<6%,2.46%and 4.27%,0 and 1.85%,respectively.Detection rate of methicillin-resistant Staphylococcus aureus(MRSA)was 21.95%.Minocycline-,vancomycin-,teicoplanin-,and linezolid-resistant Staphylococcus aureus were not detected.Conclusion The positive rate of blood culture from elderly patients is high.Major pathogens are Gram-negative bacteria,most of which are Escherichia coli and Klebsiella pneumoniae.Antimicrobial resistance varies in different pathogens.Blood culture should be performed in time to rationally use antimicrobial agents according to antimicrobial susceptibility testing results.
作者
姜雪锦
吕敏
孙吉花
纪冰
JIANG Xue-jin;LYU Min;SUN Ji-hua;JI Bing(Infection Management Office,Binzhou Medical University Hospital,Binzhou 256603,China;Department of Laboratory Medicine,Binzhou Medical University Hospital,Binzhou 256603,China)
出处
《中国感染控制杂志》
CAS
CSCD
北大核心
2023年第1期68-73,共6页
Chinese Journal of Infection Control
基金
山东省自然科学基金资助项目(ZR2020MH309)。
关键词
老年住院患者
血培养
病原菌
耐药性
elderly inpatient
blood culture
pathogen
antimicrobial resistance
