血培养病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens from blood culture

作　　者：王艳海[1] 殷宝生[1] 赵娜[1] 张文涛[1] 

机构地区：[1]鄂尔多斯市中心医院检验科,内蒙古鄂尔多斯017000

出　　处：《中华医院感染学杂志》2013年第20期5054-5056,共3页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区自然科学基金(2012MS1116)

摘　　要：目的分析医院2006年1月-2012年7月各临床科室及门诊患者血液感染的病原菌分布特点及耐药性,为临床合理用药提供参考。方法血培养采用法国生物梅里埃公司BACT/ALERT 3D全自动血培养仪对血标本进行培养,VITEK-32全自动微生物分析系统对病原菌进行鉴定和药物敏感试验;药物敏感性结果统计采用WHONET5.4软件。结果 3718份血培养标本中共检出病原菌335株,阳性率为9.01%;其中革兰阳性菌170株占50.75%,革兰阴性菌123株占36.72%,真菌39株占11.64%;分离出病原菌前5位的科室依次是儿科、血液内科、ICU、呼吸内科、心内科,分别占14.03%、11.34%、10.15%、7.76%、7.16%;从113株凝固酶阴性葡萄球菌中共检出耐甲氧西林凝固酶阴性葡萄球菌85株,占75.20%;23株金黄色葡萄球菌中共检出耐甲氧西林金黄色葡萄球菌5株,占21.70%;主要革兰阳性菌对常用抗菌药物青霉素、苯唑西林、红霉素、克林霉素的耐药率均>50.00%,而对万古霉素、利奈唑胺和喹奴普汀/达福普汀全部敏感;肠球菌属对左氧氟沙星、红霉素和庆大霉素的耐药率分别为78.3%,87%和60.8%。结论血培养的病原菌以凝固酶阴性葡萄球菌为主,耐药性较强,提示临床应做好血培养,以合理应用抗菌药物。OBJECTIVE To analyze the distribution and drug resistance of the pathogens isolated from the patients with blood infections in the clinical departments and outpatient department from Jan 2006 to Jul 2012 so as to guide the reasonable clinical use of antibiotics. METHODS 3D automated blood culture system was used to culture the blood samples, then the identification of the pathogens and the drug susceptibility testing were performed with the use of VITEK 32 auto-MicroScan system, and the data of drug susceptibility testing were statistically analyzed by using WHONETS. 4 software. RESULTS A total of 335 strains of pathogens were isolated from 3718 blood specimens with the positive rate of 9. 01%, including 170 （50. 75%） strains of gram-positive bacteria, 123 （36.72%） strains of gram-negative bacteria, and 39 （11. 64%） strains of fungi. The pediatrics department （ 14.03 %）, hematology department （ 11.34 % ）, ICU （ 10.15 %）, respiratory medicine department （ 7.76 M ）, and cardiology department （7. 16%） ranked the top five departments where the pathogens were isolated. Of 113 strains of coagulase-negative Staphylococcus, totally 85 （75. 20%） strains of methicillin-resistant coagulase- negative Staphylococcus were detected; of 23 strains of Staphylococcus aureus, 5 （21.70 ~） strains of methicillin- resistance S. aureus were detected. The drug resistance rates of the main gram-positive bacteria to the commonly used antibiotics such as penicillin, oxacillin, erythromycin,and clindamycin were higher than 50.00M, and all the strains were susceptible to vancomycin, linezolid,and quinupristin-dalfopristin; the drug resistance rate of the En- terococci to levofloxacin was 78. 3~, erythromycin 87~ ,, gentamicin 60. 8~. CONCLUSION The coagulase- negative Staphylococcus is the predominant species of pathogens isolated from the blood cultures and is high drug resistant, it is necessary to perform the blood cultures so as to reasonably use antibiotics.

关 键 词：血培养 细菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]