448份血培养阳性标本需养菌分布及耐药性分析  

Bacteria Distribution and Antimicrobial Resistance Analysis in 448 Cases of Positive Blood Cultures

作　　者：周馨[1] 叶书来[1] 马筱玲[1] 黄家祥[1] 

机构地区：[1]安徽省立医院南区,合肥230001

出　　处：《临床输血与检验》2015年第4期320-323,共4页Journal of Clinical Transfusion and Laboratory Medicine

摘　　要：目的了解本院2011～2013年血培养阳性标本细菌分布及耐药情况,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WalkAway40SI全自动微生物鉴定药敏分析仪进行鉴定和药敏实验。结果 7 210例血培养标本中共分离出448株病原菌,阳性率为6.21%,其中革兰阳性菌235株,占51.1%,以凝固酶阴性葡萄球菌、金黄色葡萄球菌为主,对万古霉素、利奈唑胺敏感性较好;革兰阴性菌197株,占44.0%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,对亚胺培南、阿米卡星的敏感性较高,但鲍曼不动杆菌耐药菌较严重。结论本院血流感染病原菌种类较多,耐药率较高。及时了解血液感染细菌的分布特征和耐药性,对减少院内感染,指导临床合理、规范使用抗菌药物具有重要意义。Objective To investigate the distribution and drug resistance of bacteria isolated from positive blood cultures from 2011 to 2013,and to provide an optimal antimicrobial therapy.Methods Blood samples were cultivated with BACT/ALERT 3Dautomated blood culture system,bacterial confirmatory and antibiotic susceptibility tests were carried out with WalkAway40 SI bacterial identification system.Results Among 448 strains of pathogenic bacteria isolated from 7 210 blood cultures,235 cases were Gram-positive,accounting for 51.1%,and dominated by coagulase negative Staphylococcus and Staphylococcus aureus with high resistance to vancomycin and linezolid.197 cases were Gram-negative,accounting for44.0%,and dominated by E.coli,Klebsiella and Pseudomonasaeruginosa with high resistance to imipenem and amikacin.The resistance of Acinetobacter baumannii,however,was serious.Conclusion A divergence of bacteria infection were noted and most of them showed a high resistance to antibiotics in nosocomial bloodstream infections.Intensive monitoring of the distribution and drug resistance of bacteria in blood culture should be carried out timely to guide rational use of antibiotics.

关 键 词：血培养 病原菌 耐药性 

分 类 号：R446.11[医药卫生—诊断学] R373[医药卫生—临床医学]