2013年血培养病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens isolated from blood culture from in 2013

作　　者：谢强[1] 曹明杰[1] 陈玲[1] 王金丽[1] 马筱玲[2] 

机构地区：[1]滁州市第一人民医院检验科,安徽滁州239000 [2]安徽省立医院检验科,安徽合肥230001

出　　处：《中华医院感染学杂志》2015年第12期2687-2688,2703,共3页Chinese Journal of Nosocomiology

基　　金：安徽省自然科学基金资助项目(11040606M205)

摘　　要：目的监测和分析血培养中的主要病原菌分布及其耐药性,以指导临床合理使用抗菌药物。方法收集医院2013年1-12月临床送检的1 005份血培养标本中分离出的病原菌,采用Bact/Alert 3D全自动血培养对血标本进行检测,阳性标本的分离菌株用MicroScan WalkAway 96PLUS进行鉴定和药敏试验。结果 1 005份血培养标本共分离出病原菌60株,检出阳性率为5.97%,其中革兰阳性菌38株占63.33%、革兰阴性菌21株占35.00%、真菌1株占1.67%;葡萄球菌属中耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)检出率分别为40.00%和93.33%,对万古霉素、利奈唑胺的耐药率均为0;大肠埃希菌和肺炎克雷伯菌中产超广谱β-内酰胺酶(ESBLs)的检出率分别为66.67%和40.00%,对亚胺培南、美罗培南、阿米卡星的耐药率均为0。结论医院血流感染的病原菌分布广、抗菌药物耐药性严重,应合理应用抗菌药物,抑制耐药菌的传播。OBJECTIVE To investigate the distribution and drug resistance of pathogens isolated from blood culture in 2013 and provide basis for clinical rational drug use .METHODS The pathogens were isolated and collected from the 1 005 blood culture samples during Jan .- Dec .2013 .The blood samples were cultivated with Bact/Alert 3D system , the bacterial confirmation and antibiotic susceptibility tests were conducted with the MicroScan WalkAway 96 PLUS bacterial identification system .RESULTS A total of 60 strains of pathogens were isolated from the 1 005 blood cultures with the positive rate of 5 .97% ,including 38 （63 .33% ） strains of gram‐positive bacteria ,21 （35 .00% ） strains of gram‐negative bacteria ,and 1 （1 .67% ） strain of fungus .The detection rate of methicillin‐resistant Staphylococcus aureus （MRSA） and methicillin‐resistant coagulase‐negative Staphylococcus （MRCNS） was 40 .00% and 93 .33% .The resistance of MRSA and MRCNS was 0 to vancomycin and linezolid . The detection rate of Escherichia coli ,ESBLs‐producing strains among K lebsiella pneumoniae was 66 .67% and 40 .00% ,and their resistance was 0 to imipenem ,meropenem and amikacin .CONCLUSION The pathogens isolated from blood culture were widely distributed and seriously resistant in nosocomial bloodstream infections . Antibacterial drugs should be used rationally so as to reduce the spread of drug resistant strains .

关 键 词：血培养 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]