目的 分析监利市人民医院成人血流感染病原菌的分布及其耐药性，为临床合理使用抗菌药物提供依据。方法 收集2016年1月—2020年12月监利市人民医院住院疑似血流感染的成年（年龄≥14岁）患者血培养阳性菌株，采用VITEK 2-Compact仪器法测定分离菌的药物敏感性，参照CLSI 2020版折点判读结果，用WHONET 5.6软件统计分析。结果 共分离出1 431株病原菌，革兰阴性杆菌占63.31%，革兰阳性球菌占35.64%，真菌占1.05%；主要为大肠埃希菌（38.50%）、凝固酶阴性葡萄球菌（19.64%）、肺炎克雷伯菌（10.83%）、金黄色葡萄球菌（5.03%）和肠球菌属（3.14%）。革兰阴性杆菌对亚胺培南、美洛培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦较敏感。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率分别为16.7%、71.2%，未发现耐利奈唑胺、万古霉素、替考拉宁和替加环素革兰阳性球菌。结论 监利市人民医院成人血流感染病原菌以革兰阴性菌为主，临床应合理应用抗菌药物，主动开展细菌耐药性监测，并加强医院感染控制遏制细菌耐药性上升。

Objective To analyze the distribution and drug resistance of pathogenic bacteria from adult blood specimens, in order to further provide the reference for rational use of antibacterial agents. Methods The strains isolated from the blood in People’s Hospital of Jianli City from January 2016 to August 2020 were collected, the identification and antimicrobial susceptibility were performed by VITEK 2-Compact. Drug resistance was judged according to CLSI 2020 and WHONET 5. 6 software was used to analyze the data. Results A total of 1 431 bacterial strains were isolated. Gram-negative bacilli, Gram-positive cocci and fungus accounted for 63.31%, 35.64%, and 1.05%，respectively. They are mainly Escherichia coli, coagulase negative Staphylococcus, Klebsiella pneumonia, Staphylococcus aureus, and Enterococcus. Gram-negative bacilli are more sensitive to imipenem, meropenem, piperacillin/ tazobactam, and cefoperazone/sulbactam. The prevalence of methicillin resistant S. aureus (MRSA) and methicillin resistant coagulase negative Staphylococcus (MRCNS) were 16.7% and 71.2%, respectively. No Gram-positive cocci was resistant to linezolid, vancomycin, teicoplanin, and tigecycline. Conclusion Gram negative bacteria are the main pathogens of bloodstream infection in adult patients in People’s Hospital of Jianli City. Promoting the rational use of antimicrobial agents and conducting bacterial resistance surveillance actively should be strengthen to prevent the increase of the bacteria drug resistance.

R978.1