关键词: 细菌分布, 耐药性, 感染途径, 血流感染, 社区感染, 医院感染

Abstract:

Objective To compare the pathogenic bacterium distribution and their drug resistance situations from community and hospital acquired blood current infection, and to investigate their routes of infection. Methods The 351 blood current infection patients were investigated for pathogenic bacterium distribution and drug resistance retrospectively. Resutls A total of 87 strains were isolated from community acquired blood current infection, and 264 strains were isolated from hospital acquired blood current infection. Their positive rates were 6.5% and 13.1%. Both of them were mainly Gram-negative bacilli. The strains resistant to carbapenem were not found. Gram-positive cocci was sensitive to vancomycin and linezolid. The pathogenic bacterium distribution from hospital acquired blood current infection and the multi-drug resistance rate were wider and higher than those from community acquired blood current infection. The detection rates of extended-spectrum beta-lactamases (ESBLs) of Escherichia coli and Klebsiella pneumoniae (37.9% and 25.0%) from hospital acquired group were higher than those from community acquired group (18.5% and 21.4%). The methicillin-resistant coagulase negative Staphylococci (MRCNS) and Staphylococcus aureus detection rates (77.8% and 45.5%) were higher than those from community acquired group (46.2% and 33.3%). The principal infection routes were intravascular catheter and urethra in hospital acquired group. The principal infection routes in community acquired group were respiratory tract and biliary tract. The pathogenic bacteria from respiratory tract, biliary tract, urethra, peritoneum and intestinal tract as the routes of infection were given priority to Gram-negative bacilli. The routes of infection through skin wound, intravascular catheter and unknown pathway mostly were Gram-positive cocci. Conclusions Generally, the resistance rate of hospital acquired group is higher than that of community acquired group. Based on the routes of infection, carbapenem, vancomycin or linezolid could be chosen, until drug susceptibility tests report.

Key words: Pathogenic bacterium distribution, Drug resistance, Route of infection, Blood current infection, Community acquired infection, Hospital acquired infection