Clinical characteristics and drug resistance of 48 cases with anaerobic bloodstream infections

doi:10.3877/cma.j.issn.1674-1358.2017.06.010

Abstract

Abstract:

Objective

To investigate the clinical characterisitics and the resistance of anaerobic bloodstream infections and to improve the diagnosis and treatment in anaerobic bacteremia.

Methods

Total of 48 cases with anaerobic bloodstream infections in our hospital were collected from January 2012 to November 2015. The clinical characterisitics, pathogens distribution and drug resistance were analyzed, respectively.

Results

The most pathogenesis of anaerobic bloodstream infections were gastrointestinal tract diseases and surgical site infections. Total of 53 strains anaerobic bacteria were isolated, and the detection rates of Gram-positive and Gram-negative anaerobic bacteria were 47.17% and 52.83%, which included Peptostreptococcus spp. (20.75%), Bacteroides fragilis (15.09%) and other Bacteroides spp. (22.64%). The positive alarming time within 48 h of Gram-negative anaerobic bacteria was significantly shorter than that of Gram-positive anaerobic bacteria. Among the 53 strains anaerobic bacteria, 100.00% were susceptible to pipperacillin-tazobactam, imipenem and vancomycin. Only 7 isolates of Bacteroides spp. were susceptible to penicillin (35.00%), 11 isolates were susceptible to clindamycin (65.00%). Eight isolates of Gram-positive bacilli (66.67%) and 11 isolates of Gram-positive cocci (86.67%) were susceptible to metronidazoleand.

Conclusions

The anaerobic bloodstream infections were majored in Gram-negative bacilli. Blood culture played a significant role in anaerobic blood infections. It was important to increase the detection rates of anaerobic bacteria and provide the antimicrobial susceptibility testing in order to reduce the incidence and mortality of anaerobic bloodstream infections.

Key words: Anaerobic bacteria, Blood infections, Drug resistance

Yan Wang, Huiying Zhang, Jun Wu, Ying Liu, Qian Liang. Clinical characteristics and drug resistance of 48 cases with anaerobic bloodstream infections[J]. Chinese Journal of Experimental and Clinical Infectious Diseases(Electronic Edition), 2017, 11(06): 573-577.

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References 24

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临床特征		数值
平均年龄（岁）		58.35 ± 21.01
性别（例，男/女）		37/11
病房[例（%）]
	普外科	6（12.50）
	泌尿外科	3（6.25）
	骨科	10（20.83）
	ICU	8（16.67）
	妇产科	3（6.25）
	内科	18（37.50）
病因[例（%）]
	呼吸系统疾病	5（10.42）
	消化系统疾病	11（22.92）
	泌尿生殖系统疾病	6（12.50）
	术后伤口感染	13（27.08）
	脓毒症	8（16.67）
	其他	5（10.42）
感染类型[例（%）]
	单独厌氧感染	40（83.33）
	混合感染	8（16.67）
感染指标[例（%）]
	体温（> 38 ℃）	38.15 ± 1.20
	WBC（10 × 10⁹/L）	15.86 ± 8.32
	CRP（mg/L）	97.33 ± 50.15
	ESR（mm/h）	70.62 ± 30.96

临床特征		数值
平均年龄（岁）		58.35 ± 21.01
性别（例，男/女）		37/11
病房[例（%）]
	普外科	6（12.50）
	泌尿外科	3（6.25）
	骨科	10（20.83）
	ICU	8（16.67）
	妇产科	3（6.25）
	内科	18（37.50）
病因[例（%）]
	呼吸系统疾病	5（10.42）
	消化系统疾病	11（22.92）
	泌尿生殖系统疾病	6（12.50）
	术后伤口感染	13（27.08）
	脓毒症	8（16.67）
	其他	5（10.42）
感染类型[例（%）]
	单独厌氧感染	40（83.33）
	混合感染	8（16.67）
感染指标[例（%）]
	体温（> 38 ℃）	38.15 ± 1.20
	WBC（10 × 10⁹/L）	15.86 ± 8.32
	CRP（mg/L）	97.33 ± 50.15
	ESR（mm/h）	70.62 ± 30.96

菌株种类		株数	构成比（%）
革兰阳性菌		25	47.17
	消化球菌属	3	5.66
	消化链球菌属	11	20.75
	放线菌属	2	3.77
	痤疮丙酸杆菌	4	7.55
	梭菌属	5	9.43
革兰阴性菌		28	52.83
	韦荣球菌属	2	3.77
	脆弱拟杆菌	8	15.09
	其他拟杆菌属	12	22.64
	普雷沃菌属	2	3.77
	梭杆菌属	4	7.55
合计		53	100.00

菌株种类		株数	构成比（%）
革兰阳性菌		25	47.17
	消化球菌属	3	5.66
	消化链球菌属	11	20.75
	放线菌属	2	3.77
	痤疮丙酸杆菌	4	7.55
	梭菌属	5	9.43
革兰阴性菌		28	52.83
	韦荣球菌属	2	3.77
	脆弱拟杆菌	8	15.09
	其他拟杆菌属	12	22.64
	普雷沃菌属	2	3.77
	梭杆菌属	4	7.55
合计		53	100.00

菌株种类	株数	时间分布
菌株种类	株数	24 h	24～48 h	48～72 h	72 h
革兰阳性菌	25	1（4.0）	8（32.0）	13（52.0）	3（12.0）
革兰阴性菌	28	5（17.9）	15（53.6）	6（2.1）	2（7.1）

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