探讨血培养阳性结果在新生儿血流感染中的意义  

Significance of blood culture positive results in judging neonatal bloodstream infections

作　　者：张斗星[1] 张林[2] 李宗光[1] 胡安群[1] 

机构地区：[1]安庆市立医院检验科,246003 [2]安庆市立医院感染管理科,246003

出　　处：《安徽医学》2012年第10期1290-1292,共3页Anhui Medical Journal

摘　　要：目的探讨新生儿血培养阳性的临床意义。方法对2011年1月至2011年12月科住院患儿血培养标本中分离到的阳性结果 116例进行分析,区别致病菌和污染菌。结果 116例血培养阳性结果中,主要为革兰阳性球菌82例(70.7%),革兰阴性杆菌33例(28.4%),白色念珠菌1例(0.9%),判断为血流感染为52例(44.8%),污染菌为64例(55.2%),污染菌主要以血浆凝固酶阴性葡萄球菌为主;MRSA、MRCNS和产ESBLs细菌在致病菌和污染菌检出率基本一致,耐药谱基本相同;致病菌的阳性报警时间明显少于污染菌报警时间。结论新生儿血培养报警阳性中,污染率较高,以血浆凝固酶阴性葡萄球菌为主,医师需将实验室结果与临床资料结合考虑,正确区分污染菌,发挥血培养的作用。Objective To explore the clinical significance of the positive blood culture results in neonates. Methods A retrospec- tive analysis of positive blood culture from 116 neonatal hospitalized patients in Anqing Municipal Hospital from January 2011 to December 2011 was done. Strains of pathogen and bacterium were identified. Results Eighty-two of 116 strains were from patients with gram-positive bacteria, 33 strains with gram negative bacilli, lstrain with candida albieans; fifty-two of 116 strains from patients with bloodstream infection and the other 64 strains with bacterium, mainly coagulase negative staphylococcus （CNS）. The detection rates of MRSA, MRCNS and ESBLs from pathogen and bacterium were basically the same and the drug resistance was also similar. The mean growth time of pathogen was signifi- cantly shorter than that of bacterium. Conclusion The incidence of coagulase negative staphylococcus bacterium in neonatal positive blood culture was relatively high. It is important for doctors to combine laboratory results with clinical materials to indentify bacterium and play the role of blood culture.

关 键 词：新生儿血流感染 血培养 致病菌 污染菌 血浆凝固酶阴性葡萄球菌 

分 类 号：R446.5[医药卫生—诊断学]