血培养病原菌的临床分布及药物敏感性分析  

Analysis on distribution and drug-resistance of pathogens in positive blood culture

作　　者：黄健宇[1] 徐鸿绪[2] 周淑红[1] 杜玲[1] 

机构地区：[1]中山大学附属第一医院东山院区检验科,广州510080 [2]中山大学附属第一医院检验医学部,广州510080

出　　处：《中国卫生检验杂志》2011年第6期1429-1431,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的:了解医院2006年1月-2009年6月血培养结果及病原菌的耐药状况,为血液感染性疾病的诊断、治疗提供依据。方法:回顾性分析我院导致血液感染的1345株病原菌的分布及其抗菌药物耐药状况。结果:从血液标本中培养分离病原菌1345株。其中革兰阴性菌550株,占40.8%,包括大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、铜绿假单胞菌、鲍曼不动杆菌;革兰阳性菌468株,占34.9%,包括金黄色葡萄球菌、表皮葡萄球菌、人型葡萄球菌、溶血葡萄球菌、屎肠球菌、粪肠球菌、草绿色链球菌;酵母菌39株,占2.9%,包括热带假丝酵母菌、白色假丝酵母菌、近平滑假丝酵母菌。革兰阴性杆菌对亚胺培南、阿米卡星的敏感性较高,革兰阳性球菌对利奈唑胺、磷霉素、万古霉素、替考拉宁较为敏感,真菌对5-氟胞嘧啶、两性霉素B、氟康唑、伊曲康唑均敏感。结论:血液感染患者菌种复杂,革兰阴性杆菌为引起菌血症的主要病原茵,药敏结果提示检出菌株耐药性强且广谱耐药,应加强病原菌耐药性监测,合理使用抗菌药物。Objective：To investigate the distribution and drug-resistance of pathogens in positive blood culture between January 2006 and September 2009 in hospital,so as to provide reference for the diagnosis and therapy of hematologic infectious diseases.Methods： Retrospective analysis was performed to analyze the distribution and drug-resistance of 1345 strains of pathogens causing hematologic infection.Results： Of 1345 isolated pathogens from the positive specimens of blood culture in our hospital,550（40.8%） were Gram-negtive bacteria,including Escherichia coli,Klebsiella pneumoniae,Enterobacter cloacae,Pseudomonas aeruginosa,Acinetobacter baumannii;468（34.9%） were Gram-positive bacteria,including Staphylococcus aureus,Enterococcus faecium,Enterococcus faecalis,streptococcus mitis Staphylococcus.epidermidis,staphylococcus hominis,Staphylococcus haemolyticus.39（2.9%） were yeast fungi;including Candida tropicalis,Candida albicans,Candida paapsilosis.Gram-negative bacilli were more sensitive to Imipenem and Amikacin.Gram-positive cocci were more sensitive to Linezolid,Fosfomycin,Vancomycin and Teicoplanin.Fungi were sensitive to 5-Flucytosine,Amphotericin B,Fluconazol and Itraconazole.Conclusion： There are varieties of pathogens isolated from blood culture.Gram-negative bacilliis the major pathogen for bacteremia in this area,which shows a serious and broad spectrum drug-resistance.It′s important to monitor the pathogens drug-resistance in order to guide reasonable clinical medication.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]