凝固酶阴性葡萄球菌血行感染的临床意义  

Evaluation of coagulase-negative staphylococci in blood cultures

作　　者：范冰[1] 梁慧[1] 周广军[1] 王瑞玲[1] 刘丽萍[1] 韩彬[1] 张薇[1] 王海燕[1] 

机构地区：[1]武警总医院检验科,北京100039

出　　处：《武警医学》2008年第9期809-811,共3页Medical Journal of the Chinese People's Armed Police Force

摘　　要：目的评估血培养中凝固酶阴性葡萄球菌（CNS）阳性的临床意义，为诊治CNS菌血症提供参考依据。方法对我院2006年1月-2007年12月血培养中分离到CNS的70例住院病例进行回顾性分析。结果70例中41例为CNS菌血症的确诊病例（58．6％），其入侵途径主要是呼吸道和患者携带的侵入性管道及人工装置。培养24h和48h之内检出的CNS中分别有38．1％和28．2％的污染菌；污染菌的平均检出时间显著长于病原菌组（54．6h／40．4h，P〈0．01）；病原菌和污染菌对常用抗生素的药物敏感性未见显著性差异（P〉0．05）。4例应用了万古霉素，均在病原菌组。结论CNS在血培养中的污染率较高，标本采集时应严格按照要求操作以减少污染；阳性结果时需综合分析临床资料和实验室数据判定其临床意义，避免滥用抗生素。Objective To evaluate the clinical significance of blood cultures positive for coagulase- negative staphylococci （CNS）. Methods We prospectively evaluated 70 inpatients with CNS- positive blood cultures from January 2006 to December 2007 in this hospital. Results From the 70 patients we identified 41 as having septicemia of CNS, accounting for 58.6%. Their invading pathways were mainly respiratory tract,inserted catheter, and prosthetic medical devices. Within 24 hours of culture and 48 hours of culture, there were contamination rates of 38.1% and 28.2% ,respectively. The mean time for positive detection in the contaminant CNS group was significantly longer than that in the pathogenic CNS group （54.6 h/40.4 h, P 〈 0.01 ）.No significant differences were found in the susceptibility of the major antibiotics between the contaminant and the pathogen groups. Conclusions There is high contamination of CNS in blood cultures. To reduce the contamination, blood drawing must be administered strictly according to the required procedure. For CNS- positive blood cultures, comprehensive analysis of the clinical and laboratory data of the patients is demanded to exclude the contamination and to avoid misuse of antibiotics in the patients.

关 键 词：血培养 凝固酶阴性葡萄球菌 菌血症 污染菌 

分 类 号：R378.11[医药卫生—病原生物学] R378.15[医药卫生—基础医学]