血培养病原菌分布及耐药性分析  

Distribution of Pathogenic Bacteria in Blood Cultures and Analysis of Their Drug Resistance

作　　者：邓红丽[1,2] 陈振华[1] 刘文恩[1] 邹明祥[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008 [2]湖南省浏阳市人民医院

出　　处：《实用预防医学》2010年第1期127-129,共3页Practical Preventive Medicine

摘　　要：目的了解我院近一年血培养中病原菌分布及其对抗菌药物的敏感情况,为临床合理应用抗菌药物提供依据。方法采用美国BD公司的BACTEC9120自动血培养仪对血培养瓶进行连续培养监测,法国生物梅里埃公司VITEK-2全自动微生物分析系统对血标本中分离的病原菌进行鉴定和药物敏感试验。药敏结果用WHONET5.4软件进行分析。结果2 614份血培养标本分离出病原菌368株,阳性率14.1%,其中革兰阳性菌187株,占50.8%;革兰阴性菌158株,占42.9%;真菌23株,占6.3%。对葡萄球菌属、肠球菌属、大肠埃希菌、克雷伯菌属、铜绿假单胞菌、不动杆菌属进行了药敏结果分析,除葡萄球菌属对万古霉素,大肠埃希菌和克雷伯菌属对亚胺培南100.0%敏感外,其余抗菌药物均有不同程度的耐药。结论目前我院血培养分离的病原菌以革兰阳性菌为主,菌种多样化,具有较高的耐药率,提示临床医生应多做血培养,以便合理应用抗菌药物。Objective To investigate the distribution and drug resistance of pathogens in blood cultures in Xiangya Hospital over the past year, and to offer a basis for optimal application of antibiotics in clinic. Methods Blood was cultured in BADTEC9120 of U.S. BD, isolated pathogen identification and their antibiotic susceptive tests were performed by the VITEK - 2 automatic system of Bio - Merieux of France,： and the result data were analyzed by WHONETS. 4 software. Results Of 2,614 blood samples, 368 samples were positive, with the positive rate of 14.1%, which contained 187 gram - positive bacteria, accounting for 50.8%, 158 gram - negative bacteria, accounting for 42.9%, and 23 fungus, accounting for 6.3%. We analyzed the drug- susceptive results of Staphylococcus spp, Enterococcus spp, Escherichia coli, Klebsiella spp, Pseud- omonas aeruginosa and Acinetobacter spp, and found that all the antibacterial drugs lost efficacy in some degree, except that the sensitivities of Escherichia coli and Klebsiella spp to imipenem and the Staphylococci spp to vancomycin were 100%. Conclusions Gram- positive cocci are the main bacteria in blood cultures, the species from which are diversified, and the drug - resistant rates of some bacteria are high. The results indicate that doctors should take more blood cultures and monitor the bacteria drug resistance for the data of etiology, so that they can utilize antibiotics more reasonably.

关 键 词：血培养 病原菌 抗生素 耐药性 

分 类 号：R378[医药卫生—病原生物学]