儿童血培养病原菌分布及耐药性分析  

Analysis of distribution and drug resistance of pathogens in blood culture sample of children

作　　者：王艳海[1] 段宝生[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23期5877-5879,共3页Chinese Journal of Nosocomiology

基　　金：内蒙古自治区自然科学基金(2012MS1116)

摘　　要：目的了解医院2008年1月-2012年10月儿童血培养标本的病原菌构成比、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 2019份血培养标本中共检测出病原菌197株,检测阳性率为9.75%;其中革兰阳性菌147株占74.62%,以凝固酶阴性葡萄球菌为主占55.33%;革兰阴性菌46株占23.35%,以肺炎克雷伯菌为主占7.61%;凝固酶阴性葡萄球菌对青霉素、苯唑西林和红霉素的耐药率为92.66%、82.57%、80.73%,革兰阳性球菌对万古霉素均敏感;肺炎克雷伯菌和大肠埃希菌对氨苄西林、头孢唑林、头孢吡肟的耐药率分别为100.00%和100.00%、80.00%和87.50%、53.33%和75.00%,主要革兰阴性杆菌对碳青霉烯类抗菌药物高度敏感。结论儿童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 understand the species ratioes, distribution features and drug resistance of pathogens isolated from the blood samples of children in the hospital from Jan. 2008 to Oct. 2012, and to provide the refer-ence for the rational clinical use of drugs. METHODS The blood samples were cultured using BACT/ALERT 3D automatic blood culture system manufactured by Biomerieux, Co, LTD （France）, and the species identification and drug susceptibility tests were performed by the VITEK-32 auto-MicroScan system. The results of the drug susceptibility tests were analyzed by WHONET5. 4 software. RESULTS Among 2019 samples, 197 strains of pathogens were detected, and the positive rate was 9.75%0. A total of 147 strains were gram-positive bacteria （76.42%）, the majority of which was coagulase negative Staphylococcus （55.33%）. A total of 46 strains were gram-negative bacilli （23.35%）, the majority of which were Klebsiella pneurnoniae （7.61%）. The drug resist-ance rates of CNS to penicillin, oxacillin and erythromycin were 92.66%%, 82.57%, 80.73%, respectively. The gram-positive cocci were sensitive to vancomycin. The drug resistance rates of K. pneumoniae and E. coli to Ampicillin, cephalosporin and cefepime were 100. 00%, 100. 00%, 80. 00%, 87. 50%, 53. 33%, 75. 00%. The gram-negative bacilli were highly sensitive to earbapenems. CONCLUSION CNS are the main bacteria in blood cul-ture of children and have high drug resistance. It is indicated that blood culture should be well performed in order to achieve the rational use of antimicrobial drugs.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]