Objective To investigate the distribution and resistance of positive pathogens isolated from blood culture and guide the use of antibiotics for clinical treatment and prevention treatment of bacteremia.Methods Collected the blood samples from 201 4 to 201 5 and cultivate by Bact ALERT 3D,pathogenic bacteria identification and antimicrobial susceptibility testing was carried out by VITEK 2 compact.The bacterial data were analyzed by WHONET 5.6 software,according to the breakpoints of CLSI 2014.Results Among the 16 751 blood culture samples, 893 cases showed positive and the positive rate was 5.3%.Among the strains,the percentage of the gram -positive bacteria was 423,including coagulase -negative Staphylococcus (62.9%),S.aureus (8.6%),Enterococcus (1 3.8%);the percentage of the gram -negative bacteria was 41 9,including Escherichia coli(47.0%),Klebsiella pneumonia(1 6.5%),Pseudomonas aeruginosa(4.9%),Stenotrophomonas maltophilia(4.5%)and Brukhoderial. cepacia(3.8%);the percentage of fungi was 5.7%,including Candida albicans(76.5%)and candida parapsilosis (23.5%).The prevalence of ESBLs producing strains was 56.0% in E.coli and K.pneumoniae.The average prevalence of methicillin -resistant strains in S.aureus(MRSA)and coagulase -negative Staphylococcus(MRCNS) was 25.0% and 67.8% respectively.Enterobacteriaceae strains were still highly susceptible to the carbapenem drug. The rate of CRE was zero.The resistance to vancomycin,linezolid and quinupristin/Dafoe leptin was not found in Staphylococcus.VRE was not found.Conclusion There was a variety of pathogens leading to bloodstream infection which show a relative sensitive resistance to many antimicrobial agents.Meanwhile,the multi -drug resistant strains may have serious consequences,and the monitoring and rational use of antibiotics should be strengthened.

Objective To explore the correlation between serum levels of retinol-binding protein(RBP)and β2-microglobulin(β2-MG)levels with the disease and disease outcome in patients with septic shock.Methods A total of 120 patients with sepsis admitted to Qinzhou Hospital of Traditional Chinese Medicine from November 2020 to November 2022 were selected as research objects,and divided into sepsis group(76 cases)and septic shock group(44 cases)according to the severity of the disease.A total of 96 healthy subjects were selected as control group.According to the 28-day disease outcome of sepsis shock group,10 patients died(worsening group)and 34 patients survived(outcome group).Serum RBP and β2-MG levels were detected by immunoturbidimetry within 24 h after admission.Serum RBP and β2-MG levels were compared among all groups.Receiver operating characteristic curve(ROC)was used to evaluate the predictive value of serum RBP and β2-MG on the disease outcome of patients with septic shock.Multivariate Logistic regression was used to analyze the related factors affecting the disease outcome of patients with septic shock.Results WBC count,procalcitonin,C reactive protein level,acute physiology and chronic health status score system Ⅱ score,se-quential organ failure assessment(SOFA)score in sepsis shock group were higher than those in sepsis group and control group,and platelet count was lower than those in sepsis group and control group,the difference was statistically significant(P＜0.05).Serum RBP and β2-MG levels in sepsis shock group were higher than those in sepsis group and control group,and the difference was statistically significant(P＜0.05).The levels of serum RBP and β2-MG in the worsening group were higher than those in the outcome group,and the differ-ence was statistically significant(P＜0.05).ROC curve analysis showed that the area under the curve of ser-um RBP and β2-MG combined to evaluate the outcome of septic shock disease was 0.910(95％CI:0.865-0.955).Multivariate Logistic regression analysis showed that serum RBP,β2-MG,C reactive protein and SO-FA score were all risk factors affecting the disease outcome of septic shock patients(P＜0.05).Conclusion The serum levels of RBP and β2-MG in patients with septic shock are increased,and the changes of both levels are related to the disease outcome.The combined application has a better predictive value for the disease outcome in patients with septic shock.