2016-2017年度血培养阳性标本病原菌的分布与耐药性分析  

Distribution and antimicrobial resistance of pathogenic bacteria from blood infection during 2016 to 2017

作　　者：周意 赖沛炼[1] 龙华婧[1] ZHOU Yi;LAI Pei-lian;LONG Hua-jing(Laboratory Department of Guangzhou TCM Hospital, Guangdong Guangzhou 51000)

机构地区：[1]广州市中医医院检验科,广东广州510000

出　　处：《医学检验与临床》2018年第11期30-33,共4页Medical Laboratory Science and Clinics

摘　　要：目的:研究该院2016~2017年度血培养阳性标本病原菌的分布及其耐药性分析,为临床预防和诊疗血流感染提供依据.方法:对2016年1月~2017年12月该院所有血培养标本阳性结果,按照CLSI2015标准,采用WHONET 5.6软件对结果进行回顾性统计分析.结果:从2016~2017年血培养标本中共培养分离出病原菌395株,其中革兰阴性杆菌202株(51.14%),革兰阳性球菌176株(44.56%),霍乱弧菌1株(0.25%),真菌16株(4.05%).病区分布前三名分别是肿瘤科81株(20.51%),重症监护室66株(16.71%)和肾病科66株(16.71%).肺炎克雷伯菌对亚胺培南耐药率为17.9%.大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶(ESBL)菌株的检出率,分别为52.2%和32.1%.结论:血培养检出病原菌分布广泛,革兰阴性杆菌检出率略高于革兰阳性球菌,出现了耐碳青霉烯类抗生素的大肠埃希菌和肺炎克雷伯菌,应引起临床的重视,避免耐药菌株的广泛传播.Objective: The present study aims to analyze the distribution and drug sensitivity analysis of pathogenic bacteria isolated from blood culture from 2016 to 2017 in this hospital, so as toprovide evidence for clinical prevention, diagnosis and treatment of bloodstream infections. Methods: All blood culture specimens w让h positive results from this hospital between January 2016 and December 2017 were collected. According to the CLSI2015 standard, retrospective analysis ofthe results was made using WHONET 5.6 software. Results: 395 clinical isolates were collected from blood culture specimens between January 2016 and December 2017, including 202 strains ofgram-negative bacteria (51.14%) , 176 strains ofgram-positive bacteria (44.56%) ,1 strain ofVibrio cholera (0.25%) and 16 strains offungi (4.05%) . The top three departments were oncology (20.51%) , ICU (16.71%) and nephrology (16.71) . The resistance rate to imipenem of Klebsiella pneumoniae was 17.9%. The detection rates of extended —spectrum p —lactamase (ESBL) produced by Escherichia coli and Klebsiella pneumoniae were 52.2% and 32.1%. Conelusion: Widespread distribution of pathogens was detected in blood cultures. The detection rate of gram—negative bacilli was slightly higher than that of gram—positive cocci. Cabapenem—resistant strains were appeared in Escherichia coli and Klebsiella pneumonia which should cause clinical attention and avoid widespread spread ofresistant strains.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]