期刊文献+

社区获得性血流感染193例临床及病原学分析 预览

Clinical characteristics and pathogen profile in 193 cases of community acquired bloodstream infection
在线阅读 下载PDF
分享 导出
摘要 目的了解社区获得性血流感染(CABSI)的临床特点及病原学特征,指导经验性抗感染治疗。方法回顾性分析遵义医学院第五附属(珠海)医院2013-2017年193例CABSI住院患者的临床和病原资料。结果193例CABSI中189例(97.9%)存在基础疾病和/或危险因素。有明确感染灶者157例(81.3%),常见原发感染部位依次为泌尿系统(62/157,39.5%)、肝胆系统(36/157,22.9%)和下呼吸道(32/157,20.4%)。病原菌以肠杆菌科细菌为主,常见病原菌依次是大肠埃希菌(47.2%)、肺炎克雷伯菌(15.0%)、凝固酶阴性葡萄球菌(10.4%)、链球菌属(7.8%)。大肠埃希菌和肺炎克雷伯菌对碳青霉烯类敏感率100%,对哌拉西林-他唑巴坦及阿米卡星的敏感率90%以上。大肠埃希菌和肺炎克雷伯菌产ESBL率分别为54.9%(50/91)和27.6%(8/29)。未检出耐万古霉素革兰阳性菌。耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)的检出率分别为35.0%和0。结论CABSI多有基础疾病和/或诱发因素,泌尿系统、肝胆系统和下呼吸道是继发血流感染的常见原发感染部位。病原菌以肠杆菌科细菌为主。 Objective To understand the clinical and pathogen characteristics of community acquired bloodstream infection(CABSI) for improving empirical antimicrobial therapy. Methods The clinical and laboratory findings of 193 CABSI cases in the Fifth Affiliated(Zhuhai) Hospital of Zunyi Medical College from 2013 to 2017 were retrospectively analyzed. Results Of the193 CABSI cases, 97.9%(189/193) had underlying diseases and/or risk factors. Primary site of infection was identified in 81.3%(157/193) of the patients. The top three primary site of infection was urinary tract(39.5%, 62/157), hepatobiliary system(22.9%,36/157) and lower respiratory tract(20.4%, 32/157). The top pathogens included Escherichia coli(47.2%), Klebsiella pneumoniae(15.0%), coagulase-negative Staphylococcus(10.4%), and Streptococcus spp.(7.8%). All the E. coli and K. pneumoniae strains were susceptible to carbapenems. More than 90% of the E. coli and K. pneumoniae strains were susceptible to piperacillin-tazobactam and amikacin. About 54.9%(50/91) of the E. coli and 27.6%(8/29) of the K. pneumoniae strains produced extended-spectrum β-lactamases(ESBLs). No vancomycin-resistant gram-positive bacteria were detected. The prevalence of MRCNS and MRSA was 35.0% and 0,respectively. Conclusions Most CABSI cases had underlying diseases and/or risk factors. The common primary site of infection associated with secondary bloodstream infection is urinary tract, hepatobiliary system, and lower respirtaory tract. Enterobacteriaceae strains are the main pathogen of CABSI.
作者 梁欣 肖寒 LIANG Xin;XIAO Han(Department of Infectious Diseases,the Fifth Affiliated Hospital of Zunyi Medical College,Zhuhai Guangdong 519400,China)
出处 《中国感染与化疗杂志》 CAS CSCD 北大核心 2019年第1期6-11,共6页 Chinese Journal of Infection and Chemotherapy
关键词 血流感染 社区获得性感染 病原菌 抗菌药物 bloodstream infection community acquired inf ection pathogen antibacterial agent
作者简介 (第一作者)通讯作者:梁欣(1979-),男,硕士,副主任医师,主要从事细菌真菌感染诊治、获得性免疫缺陷综合征诊治。E-mail:liangxin91@126.com。
  • 相关文献

参考文献7

二级参考文献54

  • 1骆俊,吴菊芳.血流感染诊断及治疗进展[J].中国抗感染化疗杂志,2005,5(2):119-123. 被引量:24
  • 2骆俊,吴菊芳,朱德妹,李光辉,张婴元,汪复.上海市华山医院血流感染患者的病原学和临床研究[J].中华传染病杂志,2006,24(1):29-34. 被引量:38
  • 3周铁丽,王赛芳,李超,刘庆中,黄海霞.医院感染败血症病原菌8年变迁及耐药性分析[J].中华医院感染学杂志,2006,16(7):825-827. 被引量:35
  • 4王露霞 徐德兴.艾滋病患者感染马尔尼菲青霉菌1例报告[J].第一军医大学学报,2001,21(5):371-371. 被引量:7
  • 5Daniel ZU, Sarah JC, James MS, et al. Age-and sex-associated trends in bloodstream infection[J]. Arch Intern Med, 2007,167 (23) : 834-839. 被引量:1
  • 6Wisplinghoff H, Bischoff T, Tallent SM, et al. Nosocomial bloodstream infections in US Hospitals: analysis of 24179 cases from a Prospective Nationwide Surveillance Study[J]. Clin Infect Dis, 2004,39 : 309-317. 被引量:1
  • 7Tumbarello M, Sanguinetti M, Montuori E, et al. Predictors of mortality in patients with bloodstream infections caused by extended-spectrum-β-lactamases-producing Enterobacteriaceae: importance of inadequate initial antimicrobial treatment [J]. Antimicrob Agents Chemother, 2007,51 (6): 1987-1994. 被引量:1
  • 8Garner JS,Jarvis WR,Emori TG,et al.CDC definitions of nosocomial infections.APIC infection control and applied epidemiology:principles and practice,1996,A-1-A-20. 被引量:1
  • 9Diekema DJ,Beekmann SE,Chapin KC,et al.Epidemiology and Outcome of Nosocomial and Community-Onset Bloodstream Infection[J].Clin Microbiol,2003,41(8):3655-3660. 被引量:1
  • 10Esel D,Doganay M,Alp E,et al.Prospective evaluation of blood cultures in a Turkish university hospital:epidemiology,microbiology and patient outcome[J].Clin Microbiology and Infection,2003,9(10):1038-1044. 被引量:1

共引文献296

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部 意见反馈