2009-2011年血培养菌群分布和耐药分析  

Distribution and drug resistance of pathogens of blood culture from 2009 to 2011

作　　者：凌文辉[1] 黄汉[2] 郭鹏豪[2] 廖康[2] 

机构地区：[1]珠海市人民医院检验科,广东珠海519000 [2]中山大学附属第一医院检验医学部,广东广州510080

出　　处：《热带医学杂志》2013年第10期1239-1241,共3页Journal of Tropical Medicine

基　　金：广东省科技厅重点攻关项目(2009A30301011)

摘　　要：目的了解血培养的病原菌分布和耐药性。方法回顾性分析中山大学附属第一医院2009-2011年血培养阳性标本的菌群分布和药敏结果。结果共1 236株病原菌,其中革兰阴性杆菌666株,占53.9%;革兰阳性菌570株,占46.1%。前5位病原菌依次为大肠埃希菌(22.1%)、凝固酶阴性葡萄球菌(22.1%)、肺炎克雷伯菌(9.2%)、金黄色葡萄球菌(7.0%)、铜绿假单胞菌(5.7%)。大肠埃希菌、肺炎克雷伯菌超广谱β内酰胺酶(ESBLs)的发生率分别为61.6%和37.9%,鲍曼不动杆菌对多种抗生素的耐药率高;革兰阳性球菌对万古霉素和利奈唑胺耐药率低,耐苯唑西林金黄色葡萄球菌(MRSA)和耐苯唑西林凝固酶阴性葡萄球菌(MRSCON)的发生率分别为46.3%和89.9%。结论血培养分离的病原菌以革兰阴性杆菌为主,主要病原菌的耐药率较高。重视血培养,及时对其病原菌的分布和耐药性进行统计分析,为临床合理使用抗菌药物提供依据。Objective To learn the distribution and drug resistance of pathogens from blood euhure specimens. Method The distribution and antimierobial susceptibility test results of pathogens from positive blood culture speeimens in the First Affiliated Hospital of Sun Yat-sen University were analyzed retrospectively. Results A total of 1 236 bacterial strains were isolated, which included 666 （53.9%） Gram-negative bacillius and 570 （46.1%） Gram-positive bacteria isolates. Eseheriehia eoli （22.1%）, Coagulase negative staphylococci （22.1%）, Klebsiella pneumonia （9.2%）, Staphylococcus aureus （7.0%） and Pseudomonas aeruginosa （5.7%） were the top five most common isolates. The incidences of Extended Spectrum β Laetamase（ESBLs） of E.eoli and K.pneumoniae isolates were 61.6% and 37.9%, respectively. The resistance rates to several antibiotics of Aeinetobaeter baumanaii were high. The resistance rates to Vaneomyein and Linezolid of Gram-positive eoeeus were low. The incidence of Methicillin-resistant Staphylococcus aureus （MRSA） and Methieillin-resistant staphylococcus eoagulase-negative （MRSCON） were 46.3% and 89.9%, respectively. Conclusions Gram-negative baeiUius were predominant among pathogens from blood culture, and the main pathogens showed high drug resistance. We should pay attention to the distribution and drug resistant analysis of the isolated pathogens, and provide rationale of the use of antibiotics.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R446.11[医药卫生—诊断学]