血培养病原菌的分布及常见菌株的耐药性分析  

Analysis of distribution and drug resistance of common pathogenic bacteria in blood culture

作　　者：卢解红[1] 伍兆民[1] 苏旺欢[1] 叶佩玑[1] 

机构地区：[1]广东省佛山市顺德区第一人民医院检验科,528300

出　　处：《检验医学与临床》2012年第1期24-26,共3页Laboratory Medicine and Clinic

摘　　要：目的了解该院血培养病原菌的分布和常见菌株的耐药特点,为临床用药治疗提供依据。方法采用BD生产的BACTEC9120血培养仪对临床送检的血液标本进行培养,并用BD公司生产的phoenix100全自动微生物鉴定和药敏系统进行细菌鉴定及药敏试验。结果 2 978例血培养标本共报警阳性317例,阳性率为10.6%。在患者首次分离的170株菌中,以革兰阴性菌为主,共111株占65.3%,革兰阳性菌46株占27.1%,真菌13株占7.6%。革兰阴性菌中以大肠埃希菌为主,占总分离菌的28.8%,占革兰阴性菌的44.1%。革兰阳性菌中以凝固酶阴性葡萄球菌为主。革兰阴性菌中大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBLs)的检出率分别为44.9%和23.1%,对美罗培南和亚胺培南保持高度抗菌活性,敏感率达100%;铜绿假单胞菌除了对氨苄西林、氨苄西林/舒巴坦、头孢唑林、头孢噻肟、氯霉素、四环素、复方磺胺等药物有很高抗药性外,对其他药物有很高的敏感性。金黄色葡萄球菌与凝固酶阴性葡萄球菌的耐甲氧西林率分别为30.0%和95.4%,未发现耐万古霉素和利奈唑胺的葡萄球菌株。结论医院应加强血培养的监测,尽早发现病原菌,及时监测病原菌的分布变化及耐药趋势,为临床诊治提供依据。Objective To investigate the distribution of pathogenic bacteria in blood culture and to observe the drug resistance of common pathogens in our hospital to provide the basis for clinical antimicrobial therapy.Methods BACTEC9120 system made by BD company was applied for the blood culture.The microorganism identification and antimicrobial resistance tests were performed with the BD phoenix100 system.Results Among 2978 blood culture samples,317 cases were alarm positive with the positive rate of 10.6%.Among 170 strains first isolated from the patient,Gram-negative bacteria were dominated,total 111 strains accounted for 65.3%,46 strains were Gram-positive（27.1%） and 13 strains were fungi（7.6%）.Among Gram-negative bacteria,Escherichia coli was dominated,accounting for 28.8% of the total isolates and 44.1% of Gram-negative bacteria.Among Gram-positive bacteria,coagulase-negative staphylococcus was dominated.The detection rates of extended spectrum β lactamase（ESBLs） producing in Gram-negative bacteria Escherichia coli and Klebsiella pneumonia were 44.9% and 23.1% respectively,showing high antibacterial activity to meropenem and imipenem with the sensitive rate of 100%.Pseudomonas aeruginosa revealed the high resistance to ampicillin,ampicillin/sulbactam,cefazolin,cephalosporins,chloromycetin,tetracycline and compound sulfa drugs and high sensitivity to other drugs.The methicillin-resistant rates of Staphylococcus aureus and coagulase-negative staphylococcus were 30.0% and 95.4% respectively,strains resistant to vancomycin and linezolid were not found.Conclusion Hospital should strengthen the monitoring of blood culture,find pathogens as early as possible,monitor the distribution change and drug resistance change trend of pathogenic bacteria in time to provide the basis for clinical diagnosis and treatment.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]