Clinical Characteristics And Etiology Of Adult Bloodstream Infections In 2016-2017 Years

Objective: To investigate the clinical characteristics,pathogenic bacteria distribution and drug resistance of adult blood stream infection(BSI)patients in Yongzhou Central Hospital from 2016 to 2017,and to provide evidence for the diagnosis and treatment of BSI.Methods: BSI was diagnosed according to the diagnostic criteria for nosocomial infection of the United States Centers for Disease Control(CDC)in 1996 and the criteria for nosocomial infection of the Ministry of Health in 2001.The drug resistance of pathogenic bacteria to antibiotics was determined by automatic instrument,and the clinical characteristics,distribution and drug resistance of BSI patients were analyzed.Results: From 2016 to 2017,490 Cases of adult bloodstream infections were found in our hospital,including 5 cases of plural bacterial infections and 5 cases of fungal infections.Community-acquired BSI(58%)was slightly higher than hospital-acquired BSI(42%).The top five areas of BSI were urology in 57 cases,neurology in 52 cases,critical medicine in 50 cases,neurosurgery in 40 cases,and respiratory medicine in 33 cases.Most of the patients had a good prognosis,89.2%(437/490)were improved or slightly improved,and 10.8%(53/490)were seriously abandoned,transferred or died.495 strains were isolated.The top five strains were Escherichia coli(44.4%(220/495),coagulase-negative Staphylococcus(13.1%(65/495),Klebsiella pneumoniae(12.5%(62/495),Staphylococcus aureus(6.3%(31/495),Enterococcus(4.8%(24/495).The detection rates of ESBL(+)of Escherichia coli and Klebsiella pneumoniae were 47.3% and 30.6%,respectively;the detection rates of methicillin-resistant Staphylococcus aureus(MRSA)and methicillin-resistant coagulase-negative Staphylococcus(MRCNS)were 25.8% and 60.0%,respectively.No vancomycin resistance was found in Staphylococcus.The resistance rate of Streptococcus to penicillin was 0%.The resistance rate of Enterococcus to penicillin was 16.7%.No Enterococcus resistant to vancomycin was found.Conclusions: From 2016 to 2017,the incidence of adult bloodstream infections in Yongzhou Central Hospital was slightly higher in community than in hospital.Enterobacteriaceae were the main pathogens.Regular monitoring of bloodstream infections is very important for guiding rational drug use and hospital infection management.