28 292份临床血液标本细菌培养结果  

Bacterial culture results of 28 292 clinical blood specimens

作　　者：孔繁林[1] 储从家[1] 管新龙[1] 李杰芬[1] 杨宇溪[1] 

机构地区：[1]玉溪市人民医院,云南玉溪653100

出　　处：《中国感染控制杂志》2011年第3期209-213,共5页Chinese Journal of Infection Control

摘　　要：目的调查某院临床送检血液标本中病原菌的分布特征。方法采用mimiⅥTAL全自动荧光血培养仪、Bact/ALERT 3D培养仪和ⅥTEK32自动细菌鉴定仪对该院1999-2008年临床送检的28 292人份55 606瓶血标本进行培养鉴定,对培养结果作统计分析。结果 28 292份临床血液标本进行需氧和厌氧培养,其中5 837份细菌培养阳性,阳性率20.63%;需氧生长和厌氧生长分别占阳性培养的83.50%(4 874/5 837)和82.30%(4 804/5 837)。共检出各种临床细菌43属117种5 837株,其中甲型副伤寒沙门菌4 486株,占76.85%,2001年(1 263株)、2004年(740株)和2006年(713株)为检出高峰年份。除外传染病因子,菌群组成以革兰阳性球菌为主,革兰阳性球菌、革兰阴性杆菌、真菌的比例为65.73:25.30:2.74。凝固酶阴性葡萄球菌占阳性检出菌(沙门菌属除外)的37.46%(493/1 316),居分离菌首位,并有逐年上升趋势(x^2=127.81,P<0.01)。近年真菌的分离率也在逐渐升高(x^2=29.77,P<0.01)。专性厌氧菌占全部分离菌的0.38%(22/5837),占除沙门菌属外的1.67%(22/1316)。结论同时做需氧和厌氧培养可以提高细菌培养的阳性检出率。甲型副伤寒沙门菌的持续检出和某些条件致病菌(凝固酶阴性葡萄球菌和真菌)的上升趋势应引起临床的高度关注。Objective To investigate the distribution characteristics of pathogens isolated from clinical blood specimens from a hospital. Methods Bacteria isolated from 55 606 bottles of 28 292 blood specimens between 1999 and 2008 were cultured and identified by mimi VITAL Blood Culture Automation System and Bact/ALERT 3D System and VITEK 32 Automicrobic System, and the culture result was analysed statistically. Results In aerobic and anaerobic culture of 28 292 blood specimens, 5 837 showed positive culture results, the positive rate was 20. 63% ; The positive rate of aerobic and anaerobic bacteria was 83.50% （4 874/5 837） and 82. 30 % （4 804/5 837）respectively. A total of 5 837 strains of 117 species of 43 genus were detected, Salmonella paratyphi A accounted for 4 486 stains （76. 85%）. The distribution showed three peaks of bacterial detection were in the year of 2001 （1 263 strains） , 2004 （740 strains） and 2006 （713 strains）. Gram-positive cocci were the main isolated bacteria ,the ratio of gram positive cocci to gram-negative bacilli and fungi was 65. 73 ： 25. 30 ： 2. 74. Coagulase negative Staphylococcus （CNS） accounted for 37. 46%（493/1 316） of the detected bacteria except Salmonella spp. , and had a tendency of increasing gradually（X2 = 127. 81,P〈0. 01）. The isolation rate of fungus was increasing gradually（X2 = 29. 77, P〈 0. 01）. The obligate anaerobes accounted for 0. 38%（22/5 837） of all isolated bacteria , and accounted for 1, 67% （22/1 316） except Salmonella. Conclusion Performing both aerobic and anaerobic culture can enhance the positive detection rate. Constant detection of Salmonella paratyphi A and increasing tendency of opportunistic pathogens （CNS and fungus） should be paid much attention to.

关 键 词：血培养 细菌培养 病原学 甲型副伤寒沙门菌 凝固酶阴性葡萄球菌 真菌 

分 类 号：R378[医药卫生—病原生物学]