4823份血培养常见病原菌的分布及耐药性分析  

Distribution and Drug Resistance of 294 Bacteria Isolates from 4 823 Blood Culture Samples

作　　者：张秀芳[1] 柴杰[1] 王小扁[1] 昝丽娜[1] 

机构地区：[1]安徽省亳州市人民医院检验科,236800

出　　处：《临床输血与检验》2015年第1期42-45,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的监测和分析本院2013年血培养标本中分离病原菌的种类、分布及耐药状况,指导临床合理运用抗菌药物。方法采用BACT/ALERT 3D全自动血培养仪对血培养标本进行检测,阳性标本分离菌株使用VITEK 2Compact进行细菌鉴定及药敏分析。结果 4 823例血培养标本中共分离出294株病原菌,阳性率为6.1%,其中革兰阳性球菌176株,占59.8%;革兰阴性杆菌98株,占33.4%;真菌4株,占1.3%;主要病原菌依次为表皮葡萄球菌、大肠埃希菌、人葡萄球菌、溶血葡萄球菌、肺炎克雷伯菌,分离率分别为25.2%、22.9%、17.3%、9.5%、4.9%。葡萄球菌属对万古霉素、替加环素、利福平的敏感性较高;大肠埃希菌和肺炎克雷伯菌对亚胺培南、哌拉西林/他唑巴坦的敏感性较高。结论本院血培养病原菌种类复杂、耐药率较高,需及时监测病原菌的分布及耐药率的变化,为临床合理、规范使用抗菌药物提供依据。Objective To investigate the distribution and drug resistance of bacteria isolated from blood cultures in 2013, and to provide a reasonable antimicrobial therapy. Methods Blood samples were cultured with BACT/ALERT3D automated blood culture system,and bacterial confirmation and antibiotic susceptibility tests were carried out with VITEK 2 Compact bacterial identification system. Results A total of 294 strains of pathogenic bacteria were isolated from 4 823 blood cultures, including 176 （59.8%） strains of gram positive cocci, 98 （33.4%） strains of gram negative bacilli and 4 （1.3%） strains of fungi. The leading pathogens were Saphylococcus epidermidis, E. coli, S. hominis, S. haemolyticus, and K. pneumoniae, accounting for 25.2% ,22.9% ,17.3% ,9.5% ,and 4.9%, respectively. Staphylococcus spp. was sen- sitive to vancomycin,tigecycline ,and rifampicin, whereas E. coli and K. pneumoniae were sensitive to imipenem,piperacillin and tazobactam. Conclusion A high rate of drug resistant bacteria strains, with various species of pathogens, was seen . The surveillance of distribution and drug resistance of bacteria should be strengthened so as to improve the clinical reasonable antibiotic therapy.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R446.11[医药卫生—诊断学] R378[医药卫生—临床医学]