6984份血培养中病原菌的分布及耐药性  

Pathogenic Spectra and Antibiotic Resistance of Bacteria Isolated from 6984 Blood Culture Samples

作　　者：范艳萍[1] 李秀文[1] 张毅华[1] 王运铎[1] 徐维家[1] 

机构地区：[1]大连市中心医院检验科,辽宁大连116033

出　　处：《中华医院感染学杂志》2010年第11期1599-1601,共3页Chinese Journal of Nosocomiology

摘　　要：目的研究医院6年血培养中常见病原菌的种类分布及耐药情况,为临床治疗菌血症提供依据。方法血培养及鉴定采用BacT/Alert 120、3D240自动血液分析系统和ATB Expression自动细菌鉴定仪,药敏试验采用K-B纸片扩散法,应用WHONET5.4软件对结果统计分析。结果 6984份血培养中分离出病原菌866株,阳性率为12.4%,其中革兰阴性杆菌占49.2%,革兰阳性菌占42.7%,真菌占8.1%;凝固酶阴性葡萄球菌占分离菌首位,其次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、鲍氏不动杆菌和粪肠球菌等;碳青酶烯类对大肠埃希菌和肺炎克雷伯菌抗菌活性最强,而对铜绿假单胞菌、鲍氏不动杆菌抗菌活性明显降低;革兰阳性球菌对糖肽类和利奈唑胺抗菌药物高度敏感。结论引起菌血症的病原菌种类复杂,临床应根据病原菌变化及耐药性及时调整抗菌药物用药。OBJECTIVE To investigate the pathogenic bacteria distribution and antibiotic resistance of the isolates from blood samples in our hospital collected in 6 continuous years, and give some advices on clinical treatment of baeteremia. METHODS Blood samples were cultivated by BacT/Alert 120 and 3D 240 automated system and pathogenic bacteria were identified by ATB Expression system. Antibiotic susceptibility tests were performed according to K-B method, and corresponding results were analyzed with WHONET 5. 4 software. RESULTS Totally 866 strains were isolated from 6984 blood samples with positive rate of 12.4%. Among the pathogens, Gram-negative bacteria accounted for 49.2%, Gram-positive ones accounted for 42.7% and fungi accounted for 8.1 %. Coagulase negative staphylococci took the first place of isolation, else from more to less were Escherichia coli , K lebsiella pneumoniae , Staphylococcus aureus , Pseudomonas aeruginosa , Acinetobacter baumannii and Enterococcus faecalis. E. coli and 142. pneumoniae showed the most antimicrobial activity to carbopenems. But the susceptibility of P. aeruginosa and Acinetobacter to carbopenems reduced. Gram-positive cocci were highly sensitive to glycopeptides and linezolid. CONCLUSIONS The causative pathogens of bacteremia are of various species and the physicians should pay attention to the changes and resistance of pathogens, and modify antibiotic treatment timely.

关 键 词：血培养 菌血症 病原菌 耐药性 抗菌药物 

分 类 号：R378[医药卫生—病原生物学]