ICU感染患者血培养病原菌分布特点及药敏分析  

Distribution and drug susceptibility analysis of blood culture-derived pathogens from patients in ICU

作　　者：马小琴[1] 沈晓华[1] 

机构地区：[1]嘉兴市中医院检验科,浙江嘉兴314001

出　　处：《中华医院感染学杂志》2012年第9期1954-1956,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解医院ICU感染患者血培养标本的病原菌分布特点及耐药性,指导临床合理使用抗菌药物。方法病原菌采用VITEK-32全自动微生物分析系统进行鉴定,药敏试验采用VITEK-32全自动微生物分析系统和K-B纸片扩散法相结合,应用WHONET5.5软件进行统计学分析所分离的病原菌分布和药敏检测结果。结果 1632例血培养阳性237例,检出病原菌256株,检出阳性率为14.5%;其中革兰阳性菌110株占43.0%,革兰阴性菌86株占33.6%,真菌60株占23.4%,革兰阳性菌以溶血葡萄球菌、人葡萄球菌为主,对万古霉素敏感,敏感率为100.0%,革兰阴性菌以洋葱伯克霍尔德菌、肺炎克雷伯菌为主,革兰阴性菌中除洋葱伯克霍尔德菌外,其他对亚胺培南、头孢哌酮/舒巴坦均较敏感,真菌以白色假丝酵母菌为主,对常用抗真菌药均较敏感。结论医院ICU血培养分离的病原菌分布范围比较广,耐药性差异较大,对血培养分离株进行早期监测和耐药性分析非常必要,可为临床医师合理应用抗菌药物提供重要依据,防止抗菌药物滥用和新耐药菌株的产生。OBJECTIVE To understand the distribution and drug resistance of pathogens from blood culture specimens of ICU patients and guide clinical rational use of antibiotics.METHODS The VITEK32 automatic microbiological analysis system was used to identify bacteria;VITEK32 automatic microbiological analysis system and Kirby-Bauer agar diffusion method were used to test in vitro drug susceptibility;WHONET5.5 software was applied to analyze the distribution of pathogenic bacteria isolated and the results of drug susceptibility tests.RESULTS Blood culture was performed for a total of 1632 cases and 237 cases were positive.256 strains of pathogens were isolated.The positive rate was 14.5%.The isolated pathogens included 110（43.0%）strains of gram-positive bacteria,86（33.6%） strains of gram-negative bacteria,and 60（23.4%） strains of fungi.Staphylococcus haemolytic and S.hominis were the main gram-positive bacteria and mainly susceptible to vancomycin with the drug susceptibility rate of 100.0%.gram-negative bacteria isolates except Burkholderia cepacia and Klebsiella pneumonia were mainly susceptible to imipenem and cefoperazone/sulbaotam.Candida albicans was the major fungi and sensitive to common antifungal agents.CONCLUSION The pathogens isolated from blood specimens in ICU are widely distributed and have great differences in the drug resistance.It is necessary to early monitor the isolates from blood culture and analyze the drug resistance,which can provide important evidence for clinicians to rationally use antibiotics and to prevent the abuse of antibiotics and new drug-resistant isolates.

关 键 词：重症监护病房 血培养 细菌分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]