血培养阳性标本病原菌分布与药敏性分析  

Distribution and drug susceptibility of pathogens cultured positive from blood specimens

作　　者：孟芝君[1] 梁红萍[1] 郭慧芳[1] 崔巧珍[1] 张燕军[1] 李连青[2] 

机构地区：[1]山西省人民医院检验科,山西太原030012 [2]山西省临床检验中心,山西太原030012

出　　处：《中华医院感染学杂志》2015年第3期559-561,共3页Chinese Journal of Nosocomiology

基　　金：国家"十一五"科技重大专项基金资助项目(2009ZX10004-203)

摘　　要：目的了解医院2009-2012年血培养标本培养阳性病原菌分布以及药敏性,为临床合理用药提供实验室依据,指导临床合理使用抗菌药物。方法回顾性分析2009-2012年4 847份血培养标本,采用法国生物梅里埃公司BacT/ALERT3D全自动血培养仪,分离菌株鉴定和药敏试验采用VITEK-60全自动细菌鉴定药敏仪。结果 4 847份血培养标本中检测阳性标本897份,阳性率18.5%;共检出病原菌897株,其中革兰阳性菌343株占38.2%,革兰阴性菌497株占55.4%,真菌57株占6.4%;主要革兰阳性菌对利奈唑胺、万古霉素敏感率均为100.0%;大肠埃希菌、肺炎克雷伯菌和阴沟肠杆菌对亚胺培南和美罗培南的敏感率为100.0%;而铜绿假单胞菌和鲍氏不动杆菌则显示较高的耐药性。结论引起患者血流感染的主要病原菌以革兰阴性菌为主,临床医师应高度重视血培养,根据药敏结果合理使用抗菌药物,减少多药耐药菌株的出现,预防控制医院感染。OBJECTIVE To understand the antibiotic resistance and drug sensitivity of pathogenic bacteria from blood culture positive specimens collected in hospital from 2009 to 2012, so as to provide the basis for clinical rational use of antimicrobial. METHODS A total of 4 847 specimens of blood culture from 2009 to 2012 were retrospectively analyzed,BacT/ALERT3D automated blood culture system was applied for the blood culture. The identification and antimicrobial susceptibility of the isolates were determined by VITEK-60 system. RESULTS A total of 897 blood specimens were positive among 4 847 blood specimens, the positive rate was 18.5%. 343 strains were gram-positive bacteria（38.2%）, 497 strains were gram-negative bacteria（55.4%）, 57 strains were fungi （6.4%）. The sensitive rate of main gram-positive bacteria to linezolid and vancomycin were 100. 0%. The sensitive rate of E. coli, K. pneumonia and Enterobacter cloacae to imipenem and meropenem were 100.0%. But P. aeruginosa and A. baumannii showed higher resistance. CONCLUSION Gram-negative bacteria are the main pathogenic bacteria of blood stream infections in the hospital. Clinicians should attach great importance to the blood culture and use the antibiotics rationally based on the susceptibility results to reduce the emergence of multi- drug-resistant strains and prevent the hospital infections.

关 键 词：血流感染 耐药性 血培养 

分 类 号：R378[医药卫生—病原生物学]