本研究旨在分析血流感染病原菌种类分布及其耐药率，为临床合理使用抗菌药物提供参考。对2014—2021年同济大学附属东方医院血培养标本分离的主要病原菌及其耐药性进行统计分析，结果显示剔除重复菌株后，本院8年血培养标本共检出病原菌1 396株，以革兰氏阴性杆菌为主，占56.3%，其次为革兰氏阳性球菌(38.4%)和真菌(5.3%)。居前8位的菌株为大肠埃希菌(21.5%)、凝固酶阴性葡萄球菌(coagulase negative Staphylococcus, CNS) (17.4%)，肺炎克雷伯菌(14.9%)、金黄色葡萄球菌(7.2%)，鲍曼不动杆菌(5.4%)，粪肠球菌(4.2%)，屎肠球菌(3.7%)和铜绿假单胞菌(3.5%)。大肠埃希菌对第3代头孢菌素的耐药率超过50%，对碳青霉烯类药物的耐药率低至1%；肺炎克雷伯菌对碳青霉烯类药物的耐药率高达46.3%；鲍曼不动杆菌对头孢类、氨基糖苷类和碳青霉烯类的累计耐药率均大于45%。耐甲氧西林金黄色葡萄球菌和耐甲氧西林凝固酶阴性葡萄球菌(methicillin-resistant coagulase-negative Staphylococci, MRCNS)分别为44.6%和74.5%的占比。

To provide reference for rational use of antibiotics in clinic, this study investigated the distribution and antimicrobial resistance of pathogens causing bloodstream infection. The main pathogenic bacteria isolated from positive blood culture specimens and their antimicrobial resistance in Shanghai East Hospital from 2014 to 2021 were statistically analyzed. After eliminating the duplicate strains, a total of 1 396 strains of pathogenic bacteria were detected in blood culture samples during the past eight years. The gram-negative bacteria, gram-positive bacteria and fungi account for 56.3%, 38.4% and 5.3%, respectively. The top eight strains were Escherichia coli (21.5%), Coagulase negative Staphylococcus (CNS) (17.4%), Klebsiella pneumoniae (14.9%), Staphylococcus aureus (7.2%), Acinetobacter baumannii (5.4%), Enterococcus faecalis (4.2%), Enterococcus faecium (3.7%) and Pseudomonas aeruginosa (3.5%). The resistance rate of Escherichia coli to third-generation cephalosporins exceeded 50%, and the resistance rate to carbapenems was as low as 1%; The resistance rate of Klebsiella pneumoniae to carbapenems was 46.3%; The cumulative resistance rate of Acinetobacter baumannii to cephalosporins, aminoglycosides and carbapenems was more than 45%; The cumulative rates of methicillin resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) were 44.6% and 74.5%, respectively.