65例血培养阳性结果的临床分析  

Clinical analysis of 65 cases of positive blood culture

作　　者：翟红岩[1] 白玉红[2] 郭闻涛[1] 左大鹏[1] 刘艳风[1] 王强[1] 

机构地区：[1]解放军第307医院感染管理科,北京100071 [2]解放军205医院妇产科,辽宁锦州121000

出　　处：《中华医院感染学杂志》2012年第9期1951-1953,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解血培养阳性标本的病原菌分布及易感因素,为临床预防血流感染和指导抗菌药物合理使用提供依据。方法采用回顾性调查法,对65例血培养阳性患者的临床资料进行统计分析。结果共分离出病原菌79株,其中革兰阴性菌52株占65.8%、革兰阳性菌16株占20.3%、真菌11株占13.9%;医院获得性血液感染分布前3位的科室依次是血液科、移植科、消化道肿瘤科;尚未发现耐万古霉素金黄色葡萄球菌和屎肠球菌及耐亚胺培南肺炎克雷伯菌、大肠埃希菌。结论大肠埃希菌是血流感染常见病原菌,万古霉素对抗革兰阳性菌有效;亚胺培南对革兰阴性菌有效;老年肿瘤患者长期使用抗菌药物和类固醇激素,使真菌感染成为严重问题;对免疫功能低下的肿瘤患者,应尽量减少静脉置管时间,加强手卫生监管力度。OBJECTIVE To investigate the distribution of pathogenic bacteria cultured from blood and the susceptible factors so as to provide bases for the prevention of bloodstream infections and rational use of antibiotics.METHODS A retrospective analysis of the clinical data of 65 cases of positive blood culture was performed.RESULTS Of totally 79 strains of pathogens isolated,there were 52 strains of gram-negative bacteria（65.8%）,16 strains of gram-positive bacteria（20.3%）,and 11 strains of fungi（13.9%）;the hospital-acquired bloodstream infections mostly distributed in department of hematology,followed by transplant department and department of gastrointestinal oncology;no vancomycin-resistant Staphylococcus aureus or Enterococcus feces were detected,and no strains of imipenem-resistant Klebsiella pneumoniae or Escherichia coli were detected either.CONCLUSION E.coli is the common pathogen causing bloodstream infections;vancomycin is very effective drug against gram-positive bacteria;imipenem is very effective drug against gram-negative bacteria;the long term use of antibiotics and steroids by the elderly tumor patients had induced serious fungal infections;for the tumor patients with autoimmune dysfunction,it is necessary to reduce the duration of intravenous catheterization and strengthen the supervision of hand hygiene.

关 键 词：血培养 病原菌 耐药性 抗菌药物 静脉置管 

分 类 号：R378[医药卫生—病原生物学]