2012年血流感染病原菌分布及耐药性分析  

Analysis of the distribution and drug resistance of pathogenic bacteria of bloodstream infections in 2012

作　　者：牛小斌[1] 荆鹏伟[2] 李永伟[1] 

机构地区：[1]河南中医学院第二附属医院检验科,河南郑州450002 [2]河南中医学院第一附属医院检验科,河南郑州450002

出　　处：《现代预防医学》2015年第12期2289-2292,共4页Modern Preventive Medicine

基　　金：河南省科技攻关项目(132102310244)

摘　　要：目的了解2012年血培养的病原菌分布及耐药性,为临床血流感染的诊断与治疗提供依据。方法采用Bac T/Alert 3D全自动血培养仪进行血培养,VITEK-2 Compact全自动鉴定药敏仪进行鉴定、药敏试验,用WHONET5.6软件对结果进行统计分析。结果从1 971份血培养标本中共分离病原菌393株,检出阳性率为19.9%;其中革兰阳性菌167株,占42.5%,革兰阴性菌140株,占35.6%,真菌86株,占21.9%。耐甲氧西林金黄色葡萄球菌和凝固酶阴性葡萄球菌的检出率分别为62.5%和85.1%,大肠埃希菌和克雷伯菌属产ESBLs的检出率分别为78.3%和75.0%,耐碳青霉烯类的肺炎克雷伯菌检出率达20.0%。真菌对伏立康唑、伊曲康唑高度敏感。结论引起血流感染的病原菌菌种复杂,耐药率高,临床应重视血培养标本送检和细菌耐药监测,合理使用抗菌药物。Objective The study was conducted to assess the distribution and drug resistance of pathogenic bacteria in blood cultures in 2012, so as to provide a reference for the diagnosis and treatment of bloodstream infections. Methods Blood cultures were prepared in a Bac T/Alert 3D instrument; VITEK-2 Compact was used for bacterial identification and drug sensitive test; and the results were statistically analyzed by WHONET5.6. Results A total of 393 strains of pathogenic bacteria were isolated from 1971 specimens of blood culture, resulting in a positive rate of 19.9%. The isolates included 167 strains of gram-positive bacteria（42.5%）, 140 strains of gram-negative bacteria（35.6%）, and 86 strains of fungi（21.9%）. The positive rates of methicillin-resistant S. aureus and coagulase negative Staphylococcus were 62.5% and 85.1%, respectively; the positive rates of ESBLs-producing E.coli and Klebsiella were 78.3% and 75.0%, respectively; and the positive rate of carbapenems-resistant K. pneumoniae was 20.0%.The fungi were highly sensitive to voriconazole and itraconazole. Conclusion Bloodstream infections are caused by a wide variety of pathogenic bacterial species, resulting in strong drug resistance. Sampling of blood cultures, monitoring of drug resistance, and rational use of antibiotics need to be emphasized.

关 键 词：血培养 血流感染 病原菌 分布 耐药性 

分 类 号：R378[医药卫生—病原生物学]