151株血培养分离菌的分布及耐药性分析  

Distribution and antimicrobial resistance analysis of 151 strains isolated from blood

作　　者：喜贺热[1] 崔永强 

机构地区：[1]巴彦淖尔市医院检验科,巴彦淖尔市015000 [2]巴彦淖尔市中心血站,巴彦淖尔市015000

出　　处：《实用检验医师杂志》2014年第4期230-233,共4页Chinese Journal of Clinical Pathologist

摘　　要：目的了解我院血培养分离病原菌的分布及耐药情况。方法收集2012年6月-2013年12月我院门诊及住院患者的1178份血液标本,采用Bact/Alert-3D全自动血培养仪进行培养,阳性标本采用VITEK-COMPACT2全自动细菌鉴定仪进行菌种鉴定,采用K-B法及VITEK-COMPACT2定量MIC药敏分析系统进行药敏试验,并采用WHONET5.4软件对菌种检出情况及耐药情况进行统计分析。结果 1178份血液标本中共分离出病原菌151株,分离率为12.8%。151株病原菌中,革兰阴性菌97株(64.2%),革兰阳性菌49株(32.5%),真菌5株(3.3%)。97株革兰阴性菌中,分离率在前三位的为大肠埃希菌(39株,25.8%)、肺炎克雷伯菌(25株,16.6%)和马耳他布鲁菌(15株,9.9%);49株革兰阳性菌中以金黄色葡萄球菌(24株,15.9%)和表皮葡萄球菌(8株,5.3%)为主,真菌多为白色念珠菌(4株,2.6%)。39株大肠埃希菌和25株肺炎克雷伯菌中,产超广谱β-内酰胺酶(extended spectrum betalactamases,ESBLs)的菌株分别为18株(46.2%,18/39)和8株(32.0%,8/25);24株金黄色葡萄球菌中,耐甲氧西林金黄色葡萄球菌的检出率为50.0%(12/24)。大肠埃希菌和肺炎克雷伯菌对庆大霉素、左氧氟沙星和环丙沙星的耐药率在40.0%以上,金黄色葡萄球菌对庆大霉素、哌拉西林/他唑巴坦、头孢西丁和红霉素的耐药率在41.7%以上。结论我院血培养分离菌以革兰阴性杆菌居多,其中马耳他布鲁菌偏多是因为本地区牧民较多所致,分离病原菌的耐药情况严重,临床医师应根据细菌鉴定及药敏试验选择敏感药物治疗。Objective To investigate the distribution and drug resistance of btood culture isolated bacteria in our hospital. Methods 1178 strains blood sample were collected in our hospital from June 2012 to December 2013. Blood sample were cultivated by the Bact/Alert-3D automatic blood culture system. The positive strains were identified by VITEK-COMPACT2 automatic bacterial identification instrument. The drug sensitivity test were detected by K-B method and VITEK-COMPACT2 quantification MIC drug sensitivity analysis system. All data were analyzed by WHONET 5.4 software. Results 151 strains of bacteria were isolated from 1178 blood samples, and the isolated rate was 12.8%. In 151 strains of bacteria, the gramnegative bacteria was 97 strains （64.2%）, gram-positive bacteria was 49 strains （32.5%）, and fungi was 5 strains （3.3%）. In 97 strains of gram-negative bacteria, isolated rates of top three were Escherichia coli （39 strains, 25.8% ）, Klebsiella pneumoniae （25 strains, 16.6% ） and Brucella melitensis （ 15 strains, 9.9% ）. In 49 strains of gram-positive bacteria, isolated rates of top two were Staphylococcus aureus （24 strains, 15.9% ） and Staphylococcus epidermidis （8 strains, 5.3%）. The mostly of fungi were Candida albicans （4 strains, 2.6% ）. In 39 strains of Escherichia coli and 25 strains Klebsiella pneumoniae, isolated rate of extended spectrum beta- lactamases were 46.2% （18/39） and 32.0% （8/25）, respectively. In 24 strains of Staphylococcus aureus, isolated rate of methicillin-resistant Staphylococcus aureus was 50.0% （12/24）. The resistant rates of Escherichia coli and Klebsiella pneumoniae to gentamicin, levofloxacin and ciprofloxacin were over 40.0%, and resistant rates of Staphylococcus aureus to gentamicin, piperacillin/tazobactam, cefoxitin and erythromycin were over 41.7%. Conclusion The gram-negative bacteria are majority in the blood culture isolated bacteria. The mroe herdsman in our region result in the much more Brucella melitensis. The drug resistance

关 键 词：血培养 分离菌 抗生素 耐药性 

分 类 号：R446.5[医药卫生—诊断学]