2003-2009年血标本分离病原菌分布及其药敏分析  

Drug susceptibility and distribution of isolates from blood specimens from 2003 to 2009

作　　者：徐瑗瑗[1] 徐少宝[1] 熊自忠[2] 吴晓玲[1] 

机构地区：[1]安徽医科大学附属省立医院感染病科,安徽合肥230001 [2]安徽医科大学附属第一医院感染病科,安徽合肥230022

出　　处：《中华医院感染学杂志》2011年第10期2103-2105,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院2003-2009年血培养中分离的病原菌分布及耐药性,为临床治疗提供用药依据。方法回顾性分析医院2003年1月-2009年12月血培养标本中分离的菌株,并进行菌株鉴定和药物敏感试验。结果 21 372份血培养标本分离出病原菌1404株,阳性率6.5%;革兰阳性菌768株占54.7%,革兰阴性菌547株占39.0%,真菌89株占6.3%,复数菌感染21例占1.5%;其中凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌分别占31.1%、20.6%、7.9%,葡萄球菌属中,耐甲氧西林金黄色葡萄球菌、耐甲氧西林凝固酶阴性葡萄球菌分别占52.3%和85.4%,耐甲氧西林葡萄球菌(MRS)显示多药耐药性,对大多数药物的耐药性显著高于甲氧西林敏感葡萄球菌(MSS),未发现万古霉素耐药株,大肠埃希菌、肺炎克雷伯菌中产ESBLs菌株的检出率分别为57.8%、36.5%,产ESBLs菌株显示多药耐药性,对大多数药物的耐药性显著高于非产ESBLs菌株;铜绿假单胞菌除对亚胺培南、头孢他啶较为敏感外,对其他抗菌药均有较高的耐药性。结论医院血培养分离的病原菌分布较广,葡萄球菌属、大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌是主要分离菌株,且耐药显著。OBJECTIVE To investigate the distribution and resistance of isolates from blood specimens in our hospital from 2003 to 2009.METHODS Isolates′ distribution and resistance were retrospectively studied in 21371 blood samples from Jan 2003 to Dec 2009.RESULTS A total of 1404 bacteria were isolated from 21371 blood samples,including 768 Gram-positive bacteria（54.7%）,547 Gram-negative bacteria（39.0%）,89 strains of fungi（6.3%） and 21 complex pathogen（1.5%）.Rates of MRSA and MRCoNS were 52.3 % and 85.1 %.MRS were multi-resistant and the resistance rate of MRS was higher than MSS.There was no isolates resistant to vancomycin in Staphylococcus spp.The prevalence of extended-spectrum β-lactamases（ESBLs） were 57.8 % and 36.5 % in E.coli and K.pneumoniae,respectively.The resistance rate of ESBLs producers with multi-resistance was higher than non-ESBLs producers.Except for imipenem and ceftazidime,most of P.aeruginosa were resistant to other antimicrobial agents.The drug resistance of it to other kinds of antibiotics were higher.CONCLUSION The distribution of isolates from the blood culture are extend in our hospital.Staphylococcus spp.,E.coli,K.pneumoniae and P.aeruginosa are common in those isolates and resistant to most of antimicrobial agents.

关 键 词：血培养 分离菌 抗菌药物 耐药性 

分 类 号：R378[医药卫生—病原生物学]