Gohel Kalpesh, Jojera Amit, Soni Shailesh, Gang Sishir, Sabnis Ravindra, Desai Mahesh
Muljibhai Patel Urological Hospital and Society for Research in Nephro-Urology, Dr. V. V. Desai Road, Nadiad, Gujarat 387001, India.
Biomed Res Int. 2014;2014:153747. doi: 10.1155/2014/153747. Epub 2014 Apr 7.
Blood stream infections can lead to life threatening sepsis and require rapid antimicrobial treatment. The organisms implicated in these infections vary with the geographical alteration. Infections caused by MDR organisms are more likely to increase the risk of death in these patients. The present study was aimed to study the profile of organisms causing bacteremia and understand antibiotic resistance patterns in our hospital. 1440 blood samples collected over a year from clinically suspected cases of bacteremia were studied. The isolates were identified by standard biochemical tests and antimicrobial resistance patterns were determined by CLSI guidelines. Positive blood cultures were obtained in 9.2% of cases of which Gram-positive bacteria accounted for 58.3% of cases with staph aureus predominance; gram negative bacteria accounted for 40.2% with enterobactereciea predominence; and 1.5% were fungal isolates. The most sensitive drugs for Gram-positive isolates were vancomycin, teicoplanin, daptomycin, linezolid, and tigecycline and for Gram-negative were carbapenems, colistin, aminoglycosides, and tigecycline. The prevalence of MRSA and vancomycin resistance was 70.6% and 21.6%, respectively. ESBL prevalence was 39.6%. Overall low positive rates of blood culture were observed.
血流感染可导致危及生命的败血症，需要迅速进行抗菌治疗。这些感染中涉及的病原体因地域变化而异。由多重耐药菌引起的感染更有可能增加这些患者的死亡风险。本研究旨在研究我院引起菌血症的病原体特征，并了解抗生素耐药模式。对一年来从临床疑似菌血症病例中采集的1440份血样进行了研究。通过标准生化试验鉴定分离株，并根据CLSI指南确定抗菌药物耐药模式。9.2%的病例血培养呈阳性，其中革兰氏阳性菌占58.3%，以金黄色葡萄球菌为主；革兰氏阴性菌占40.2%，以肠杆菌科为主；1.5%为真菌分离株。革兰氏阳性分离株最敏感的药物是万古霉素、替考拉宁、达托霉素、利奈唑胺和替加环素，革兰氏阴性菌最敏感的药物是碳青霉烯类、黏菌素、氨基糖苷类和替加环素。耐甲氧西林金黄色葡萄球菌（MRSA）和万古霉素耐药的发生率分别为70.6%和21.6%。超广谱β-内酰胺酶（ESBL）的发生率为39.6%。总体血培养阳性率较低。
