Distribution Characteristics and Drug Resistance Changes of Clinical Common Blood Culture Pathogens from 2015 to 2017
CHEN Ming-hui, SUN Lan-ju, FANG Jie, et al.
Department of Laboratory Science, Tianjin
Nankai Hospital, Tianjin (300100), China
Abstract:
Objective To investigate the distributional characteristics and drug resistance transition of the common pathogens from clinical blood cultures and provide the guidelines for the clinical treatment of bloodstream infections and monitoring of infections in the hospital. Methods The blood culture samples in Tianjin Nankai Hospital between 2015 and 2017 were collected and cultivated with BacT/Alert 3D automated blood culture system, and the identification of bacteria and susceptibility test were performed by Vitek 2 Compact bacterial automatic analyzer. The results were analyzed based on whonet 5.6 and SPSS 20.0 software. Results A total of 1834 strains of pathogens were isolated from blood. There were 732 strains (39.91%) of Gram-positive bacteria, 968 strains (52.78%) of Gram-negative bacteria, 84 strains (4.58%) of fungi and 50 strains (2.73%) of anaerobic bacteria. Coagulase negative Staphylococcus was the highest in Gram-positive cocci, followed by Enterococcus faecium, Staphylococcus aureus and Enterococcus faecalis. The main species of Gram-negative bacteria were Escherichia coli, Klebsiella pneumoniae, and Pseudomonas aeruginosa. They mainly distributed in hepatobiliary and pancreatic surgery, intensive care unit and minimally invasive surgery. In 2015–2017, the resistance rates of Staphylococcus hominis and Staphylococcus epidermidis to quinolones increased significantly (P<0.05), and the resistance rate of Staphylococcus aureus to tetracycline decreased year by year (P<0.01). The resistance rates of Escherichia coli to piperacillin, ceftazidime, first, second and fourth generation cephalosporins, ampicillin/sulbactam and aztreonam were all decreased (P<0.05). The resistance rate of Klebsiella pneumoniae pneumonia to piperacillin and tobramycin decreased (P<0.05), the resistance rate to levofloxacin, piperacillin/ tazobactam, cefotetan and amikacin increased (P<0.05), and trains resistant to imipenem and meropenem appeared in 2016. The resistance rates of Pseudomonas aeruginosa to imipenem, aztreonam and quinolones were significantly decreased (P<0.05). Conclusion The blood culture pathogens in our hospital are mainly Gram-negative bacilli. Escherichia coli has high resistance to various antibiotics. The resistance rate of Klebsiella pneumoniae to some antibiotics has increased significantly, and both of them have Carbapenem resistance. Antibiotics should be used rationally and we need to strengthen the monitoring of bloodstream infection pathogens.
Key words: Blood culture; pathogenic bacteria; antimicrobial resistance
