2004～2007年医院血培养病原菌的种类及耐药性变迁  

Distribution and changing pattern of susceptibility of blood culture isolates in 2004～2007

作　　者：王炜[1] 许淑珍[1] 

机构地区：[1]首都医科大学附属北京友谊医院,北京100050

出　　处：《陕西医学杂志》2011年第2期188-191,共4页Shaanxi Medical Journal

摘　　要：目的:调查我院2004～2007年血标本中的病原菌种类和主要病原菌的耐药性变迁。方法:全部菌株均由VITEK-2 compact全自动微生物鉴定仪鉴定;依据美国临床实验室标准化研究所(CLSI)推荐的纸片扩散法进行药敏试验。结果:2004～2007年血标本分离的主要细菌是凝固酶阴性的葡萄球菌(CNS)、大肠埃希菌、肠球菌。药敏结果显示,大肠埃希菌、肺炎克雷伯菌对亚胺培南和舒普深的敏感率较高。金黄色葡萄球菌和耐甲氧西林的葡萄球菌对万古霉素的敏感性是100%。肠球菌对万古霉素、氯霉素和替考拉宁的敏感性较高。铜绿假单胞菌对头孢哌酮-舒巴坦的敏感性较高。结论:我院血培养的总数逐年增加,阳性率亦有升高的趋势。革兰阳性球菌的分离数略大于革兰阴性菌的分离数。分离菌中革兰阳性菌主要以金黄色葡萄球菌和肠球菌为主,革兰阴性菌主要以大肠杆菌和铜绿假单胞菌为主。碳青酶烯类为治疗大肠埃希菌引起严重血液感染的首选抗生素。产ESBLs肺炎克雷伯菌和非产ESBLs菌引起感染的治疗不同,临床医师应根据药敏结果选择治疗药物。临床上治疗耐甲氧西林金黄色葡萄球菌(MRSA),首选万古霉素。铜绿假单胞菌对头孢哌酮-舒巴坦的敏感性较高,主张联合用药。Objective：To investigate the distribution and changing pattern of susceptibility of blood culture isolates from 2004～2007.Methods：All isolates were identified by VITEK-2 compact automatic micobiological identification equipment.According to CLSI＇s guideline,antimicrobial susceptibility tests were performed with disk diffusion method.Results：The main bacterium identified from the blood specimen from 2004 to 2007 were coagulase negative Staphylococcus、Escherichia coli、Enterococcus spp.According to results of antimicrobial susceptibility tests,the susceptibility of Escherichia coli and Klebsiella spp to imipenem and sulperazon were 100%.The susceptibility of Staphylococcus aureus and MRSA to vancomycin were 100%.The susceptibility of Enterococcus spp to vancomycin、chloramphenicol and teicoplanin were high.The susceptibility of Pseudomonas aeruginosa to Sulperazon was high.Conclusion：The sum total of blood culture in our hospital are gradualy increasing year by year and the positive rates are elevating tendency.The separation rates of gram positive coccus are a little exceeding the gram negative baterium.Gram positive coccus are mainly Staphylococcus aureus and Enterococcus spp.Gram negative baterium are mainly Escherichia coli and Pseudomonas aeruginosa.Carbapenem are the first choice antibiotics to cure serious blood infection caused by Escherichia coli.The cure of infection caused by Klebsiella spp induced ESBL and Klebsiella spp not-induced ESBL are different.The clinician should choice antibiotics by antimicrobial susceptibility tests.The first choice antibiotics is vancomycin to cure MRSA.Sulperazon have high susceptiblity to Pseudomonas aeruginosa and advocate combine drugs.

关 键 词：医院科室 感染 细菌 微生物敏感性试验 

分 类 号：R446.5[医药卫生—诊断学]