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目的分析肾病患者血培养阳性病原菌的分布和耐药性,指导临床合理用药。方法对某医院2014年-2015年肾内科住院患者血培养阳性病原菌分布及药敏结果进行回顾性分析。结果 1 052份血培养标本中共分离出病原菌111株,总阳性率为10.5%,其中革兰阴性菌41株,占36.9%;革兰阳性菌62株,占55.9%;真菌8株,占7.2%。革兰阴性菌中检出率前3位分别是大肠埃希菌(16.2%)、肺炎克雷伯菌(9.9%)和铜绿假单胞菌(6.3%);革兰阳性菌中检出率最高的是金黄色葡萄球菌(28.8%)和凝固酶阴性葡萄球菌(20.7%);真菌检出率最高的分别是白色假丝酵母菌(3.6%)和光滑假丝酵母菌(1.8%)。大肠埃希菌和肺炎克雷伯菌对亚胺培南最为敏感;葡萄球菌对万古霉素、利奈唑胺、喹奴普汀-达福普汀、替加环素均敏感。结论临床应根据病原菌变化及耐药性及时调整抗菌药物。
Objective To analyze the distribution and drug resistance of blood-borne positive pathogens in patients with nephropathy and to guide clinical rational use of drugs. Methods Retrospective analysis was performed on the distribution of blood-borne pathogens and drug susceptibility in inpatients with renal medicine from 2014 to 2015 in a hospital. Results A total of 111 strains of pathogens were isolated from 1052 blood culture specimens, with a total positive rate of 10.5%, of which 41 strains were Gram-negative bacteria (36.9%), 62 strains were Gram-positive bacteria (55.9%) and 8 were fungi %. Gram-negative bacteria in the first three were Escherichia coli (16.2%), Klebsiella pneumoniae (9.9%) and Pseudomonas aeruginosa (6.3%); Gram-positive bacteria in the detection rate Staphylococcus aureus (28.8%) and coagulase-negative Staphylococcus aureus (20.7%) were the highest, while Candida albicans (3.6%) and Candida glabrata (1.8%) were the highest fungi. Escherichia coli and Klebsiella pneumoniae were the most sensitive to imipenem; Staphylococcus aureus were sensitive to vancomycin, linezolid, quinupristin-dalfopristin and tigecycline. Conclusion Clinical should be based on changes in pathogens and drug resistance and timely adjustment of antimicrobial agents.