940株血培养分离菌的临床分布及抗菌药物敏感性分析  

940 major blood culture positive pathogens and their antibiotic susceptibility analysis

作　　者：王运铎[1] 吕鹏[2] 张毅华[1] 刘毅[1] 

机构地区：[1]大连市中心医院检验科,辽宁大连116033 [2]大连医科大学附属二院,辽宁大连116023

出　　处：《中国微生态学杂志》2015年第5期584-587,592,共5页Chinese Journal of Microecology

摘　　要：目的定期对医院血流感染分离菌的分布和抗菌药物敏感性进行分析,为菌血症的治疗提供可靠的药敏结果,提高治愈率。方法对大连市中心医院2010年1月至2013年12月8 277份血标本采用全自动血培养仪Bac T/Alert3D和Micro Scan Walk Away-40全自动细菌鉴定仪进行细菌培养、鉴定和抗生素敏感性试验。结果 8 277份血标本中检出病原菌940株,阳性率为11.4%。940株病原菌中革兰阳性菌441株,占46.9%;以金黄色葡萄球菌、凝固酶阴性葡萄球菌、屎肠球菌、粪肠球菌和肺炎链球菌为主;革兰阴性杆菌486株,占51.7%,以大肠埃希菌、肺炎克雷伯菌、阴沟肠杆菌、鲍曼不动杆菌和铜绿假单胞菌为主;真菌13株,占1.4%。大肠埃希菌、肺炎克雷伯菌对亚胺培南、美洛培南高度敏感;鲍曼不动杆菌对头孢哌酮/舒巴坦、米诺环素高度敏感;粪肠球菌、屎肠球菌、葡萄球菌对达托霉素、万古霉素、利奈唑胺、奎奴普丁/达福普汀高度敏感。结论血液培养意义重大,病原菌分布呈多样化趋势,且表现为多重耐药。Objective To analyze the major pathogens isolated from blood cultures and their antibiotic susceptibility for the purpose of providing clinical useful treatment information. Methods 8,277 samples subjected to detection by BacT/Alert3D automated blood culture system were collected from Dalian Central Hospital from Jan. 2010 to Dec. 2013. The bacterial identification and drug susceptibility testing was carried out by using the MicroScan WalkAway-40 automatic microbial analyzer. Results 940 pathogens were isolated from 8,277 blood culture. The total positive rate was 11.4%. Gram-positive cocci were 441 strains, accounting for 46. 9% of the detected patho- gens. Most of them were coagulase-negative Staphylococci, Enterococcus faecium, Staphylococcus aureus, Enterococ- cusfaecalis and Streptococcus pneumonia. 486 Gram-negative bacilli were isolated, covering 51.7% of the positive rate. The major pathogens were Escherichia coli, Klebsiella pneumonia, Acinetobctcter baumannii, Pseudomonas aeruginosa and Enterobacter cloacae. 13 fungi were isolated, accounting for the positive rate of 1.4%. Escherichia coli and Klebsiella pneumoniae were susceptible to imipenem and meropenem. Acinetobacter baumannii was suscep- tible to Cefoperazone/Sulbactam and minocycline. The Gram＇s positive cocci were susceptible to daptomycin, lin- ezolid, vancomycin and Quinupristin-Dalfoprisdn. Conclusion The significance of blood culture was evident and the profiles of the isolated pathogen distribution were of broad. Most of the isolated strains were resistant to multiple antibiotics.

关 键 词：血培养 致病菌 药物敏感性 

分 类 号：R378[医药卫生—病原生物学]