ABSTRACT
OBJECTIVE： To investigate the clinical distribution and drug resistance of pathogenic bacteria of bloodstream infection in Zigong area， and to provide reference for the diagnosis and treatment of bloodstream infection in the region. METHODS： The blood culture positive strains and drug susceptibility results of 3 third-class comprehensive hospital of Zigong district during Jan.-Dec. 2017 were collected. Using Escherichia coli ATCC25922， Staphylococcus aureus ATCC25923， Pseudomonas aeruginosa ATCC27853， Streptococcus pneumoniae ATCC49619 as quality control bacteria， clinical distribution and drug resistance of pathogens of bloodstream infection were analyzed by using WHONET 5.6 and SPSS 19.0 software. RESULTS： A total of 879 strains of bacteria were isolated， including 212 strains of Gram-positive bacteria （24.1％） and 667 strains of Gram-negative bacteria （75.9％）. Top 5 bacteria were E. coli （50.7％）， Klebosiella pneumoniae （10.2％）， Staphylococcus aureus （6.5％）， S. epidermidis （3.2％） and S. pneumoniae （2.6％）， respectively. The age and gender distribution of pathogenic bacteria was 88.5％ in the population over 40 years old， and the scale of male to female was 1.15 ∶ 1. Drug resistance of common Gram-positive bacteria showed that S. aureus， Coagulase negative staphylococcus， Enterococcus faecalis， Enterococcus faecium and S. pneumoniae resistant to vancomycin and linezolid were not isolated； the detection rates of MRSA and MRCN were 15.8％ and 64.2％， respectively. E. faecium was more resistant to common antibiotics than E. faecalis. Drug resistance rate of E. faecalis to penicillin and ampicillin was 0， and penicillin-resistant S. pneumoniae was not detected. The drug resistance of common Gram-negative bacteria showed that E. coli and K. pneumoniae resistant to ertapenem were not isolated. The drug resistance of two bacteria to amikacin， cefotetan， cefepime， piperacillin/tazobactam and imipenem were lower （＜10％）， among which the detection rates of ESBLs-producing stain were 42.2％ and 24.4％； detection rate of ESBLs-producing stain to common antibiotics was higher than that of non-producing ESBLs stain. The resistance of Acinetobacter baumannii was higher than that of P. aeruginosa to common antibiotics， and the resistant rates to imipenem were 68.8％ and 13.6％， respectively. And amikacin-resistant or tobramycin-resistant P. aeruginosa were not isolated. CONCLUSIONS： The bloodstream infection is mainly caused by Enterobacteriaceae in Zigong area， and the drug resistance of A. baumannii is serious. It is necessary to strengthen the hospital infection control and management.