Peng Zhenli, Wang Yanxin, Jia Lijuan, Jiang Yao, Li Xiang
Clin Lab. 2023 Jan 1;69(1). doi: 10.7754/Clin.Lab.2022.220223.
This paper is to explore the composition and antibiotic resistance of pathogens isolated from blood cultures of patients with bloodstream infection (BSI) in the intensive care unit (ICU).
A retrospective study has been performed to identify the pathogens isolated from blood cultures of 147 patients with BSI in the ICU of our Hospital over 12 years (January 2008 to December 2019). The antibiotic resistance and susceptibility of the isolates were tested.
Among the 152 pathogens isolated from positive blood cultures, 61.84% were Gram-positive bacteria, 34.87% were Gram-negative bacteria, and 3.29% were fungi. The most frequently isolated pathogens were coagulase-negative Staphylococci, Staphylococcus aureus, and Escherichia coli. The pathogen distributions remained stable over 12 years. Gram-positive cocci were highly susceptible to vancomycin, linezolid, and teicoplanin. Extended-spectrum β-lactamase-producing pathogens were highly susceptible to amikacin, imipenem, meropenem, and polymyxin B. Acinetobacter were relatively sensitive to amikacin, trimethoprim-sulfamethoxazole, and polymyxin, whereas Pseudomonas aeruginosa were sensitive to amikacin, gentamicin, levofloxacin, imipenem, meropenem, and ciprofloxacin, with resistance rates less than 30%.
Gram-positive bacteria were the dominant pathogens isolated from blood cultures of ICU-BSI patients and were susceptible to vancomycin, linezolid, and teicoplanin. The antibiotic susceptibility of Gram-negative bacteria varies greatly. Our results provide important information to guide the treatment decisions in the management of ICU-BSIs.
本文旨在探讨重症监护病房（ICU）血流感染（BSI）患者血培养分离出的病原体组成及耐药情况。
进行一项回顾性研究，以确定我院ICU 12年（2008年1月至2019年12月）期间147例BSI患者血培养分离出的病原体。对分离株进行抗生素耐药性和敏感性测试。
从阳性血培养中分离出的152种病原体中，革兰氏阳性菌占61.84%，革兰氏阴性菌占34.87%，真菌占3.29%。最常分离出的病原体是凝固酶阴性葡萄球菌、金黄色葡萄球菌和大肠杆菌。病原体分布在12年期间保持稳定。革兰氏阳性球菌对万古霉素、利奈唑胺和替考拉宁高度敏感。产超广谱β-内酰胺酶的病原体对阿米卡星、亚胺培南、美罗培南和多粘菌素B高度敏感。不动杆菌对阿米卡星、复方磺胺甲恶唑和多粘菌素相对敏感，而铜绿假单胞菌对阿米卡星、庆大霉素、左氧氟沙星、亚胺培南、美罗培南和环丙沙星敏感，耐药率低于30%。
革兰氏阳性菌是ICU-BSI患者血培养分离出的主要病原体，对万古霉素、利奈唑胺和替考拉宁敏感。革兰氏阴性菌的抗生素敏感性差异很大。我们的结果为指导ICU-BSIs的治疗决策提供了重要信息。
