血培养中病原菌的分布及耐药分析  

Distribution and resistance of pathogentic bacteria in blood culture

作　　者：吴均竹[1] 侯伶俐[2] 周作华[1] 杨宏伟[1] 张珍[1] 仇少荣[1] 

机构地区：[1]郧阳医学院附属太和医院,湖北省十堰市442000 [2]湖北省十堰市红十字医院

出　　处：《实用诊断与治疗杂志》2007年第3期178-180,共3页Journal of Practical Diagnosis and Therapy

摘　　要：目的:了解血培养中分离菌株的构成比及耐药情况。方法:标本经BacT/Alerti120血培养仪培养,分离所得菌株用法国梅里埃API系统进行鉴定和K-B法做药敏。结果:在2046份标本中,分离菌株279株,阳性率为13.63%。其中革兰阳性菌占85.66%,革兰阴性菌占14.33%,耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率非常高,达69.45%(116/167),远远高于MRSA的检出率15.62%(5/32)。药敏结果显示未发现耐万古霉素的阳性球菌。MRCNS中复方磺胺甲恶唑、青霉素、红霉素、环丙沙星、克林霉素,氯霉素、四环素的耐药率分别为100%,100%,100%,100%、66.7%、66.7%,33.3%;耐甲氧西林金黄色葡萄球菌(MRSA)中分别为100%,100%,80%,20%,40%,40%,60%。在粪肠球菌药敏中青霉素、氨苄西林始终保持较稳定的抗菌活性,耐药率均<10%,对万古霉素最敏感。革兰阴性菌对第一、第二代头孢菌素耐药都在50%以上,对喹诺酮类如环丙沙星耐药高达60%,对碳青酶烯类最敏感。结论:及时掌握血培养中细菌分布与其对抗菌药物耐药现象和动态,对合理用药具有重要意义。Objective To investigate the distribution and drug-resistance of the bacteria isolated from blood in our hospital during last two years. Methods Bacteria in blood was cultured with BacT/ Alert 120, and identified with API identified tests （API Inc, France）. Antibiotics sensitivity was examined with Kirby-Bauer（K-B） method. Results Two hundred and seventy-nine strains of bacteria were isolated from 2046 blood culture samples, Gram-negative bacteria strains （85. 66%）, grampositive bacteria strains（14. 33%）. The positive rate of MRCNS was much higher than that of MRSA （69.45% vs 15.62%）. No resistance to vancomycin was found in these strain. The drug-resistance of MRCNS to trimethoprim/sulfamethoxazole （ 100 %）, penicillin G （ 100 %）, erythromycin （ 100 %）, ciprofloxacin （100%）, clindamycin （66.7%）, chloramphenicol （66.7%）, tetracycline （33.3%） were higher than that of MRSA to these drugs （100%, 100%, 80%, 20%, 40%, 40% and 60% respectively）. Resistance of enterococus faecalis to penicillin G, ampicillin was smaller than 10%. Gram negative bacteria was sensitive to carbopenems. Its resistance to first and second generation of cephlosporins was higher than 50%, and higher than 60% to quinolones resistance. Conclusion The distribution and their drug resistance characteristics of pathogenic bacteria in septicemia are important to the application of antibiotics.

关 键 词：血培养 病原菌 细菌耐药 

分 类 号：R446.5[医药卫生—诊断学]