目的 了解血流感染分離菌的分布及耐藥特征，為臨床防治血流感染提供指導(dǎo)和依據(jù)。方法 收集2018年1月—2020年12月鄭州市第七人民醫(yī)院血培養(yǎng)分離的非重復(fù)菌株，采用WHONET5.6軟件統(tǒng)計(jì)菌株的分布及耐藥特征。結(jié)果 共分離546株菌株，革蘭陰性菌302株（55.31%），革蘭陽(yáng)性菌220株（40.29%），真菌24株（4.40%）。前6位分離菌依次為凝固酶陰性葡萄球菌（CNS，23.44%）、大腸埃希菌（18.68%）、肺炎克雷伯菌（14.84%）、金黃色葡萄球菌（6.04%）、鮑曼不動(dòng)桿菌（4.21%）和銅綠假單胞菌（3.85%）。大腸埃希菌對(duì)碳青霉烯類最敏感，肺炎克雷菌碳對(duì)美羅培南和亞胺培南的耐藥率分別為30.86%和35.80%，鮑曼不動(dòng)桿菌耐藥較嚴(yán)重，耐甲氧西林凝固酶陰性葡萄球菌（MRCNS）和耐甲氧西林金黃色葡萄球菌（MRSA）的檢出率分別為72.66%、42.42%，未發(fā)現(xiàn)利奈唑胺和萬(wàn)古霉素耐藥的葡萄球菌。結(jié)論 革蘭陰性菌是醫(yī)院血流感染的主要致病菌，細(xì)菌耐藥情況復(fù)雜，臨床要根據(jù)藥敏結(jié)果合理選擇抗菌藥物。

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.

R978.1

河南省醫(yī)學(xué)科技攻關(guān)計(jì)劃聯(lián)合共建項(xiàng)目（LHGJ20191137）