2012-2014年住院病人血培养阳性标本病原菌分布及耐药性分析  

Distribution of pathogenic agents and antimicrobial resistance in positive blood culture specimens sampled from inpatients from 2012 to 2014

作　　者：严佳斌 马蔡昀[2] 

机构地区：[1]江苏盛泽医院检验科,江苏吴江215228 [2]江苏省人民医院检验科,江苏南京210029

出　　处：《中国病原生物学杂志》2015年第12期1136-1139,1143,共5页Journal of Pathogen Biology

摘　　要：目的调查2012-2014年江苏盛泽医院住院病人血培养阳性标本中病原菌分布及其耐药性,为制定预防控制血液感染措施提供参考依据。方法采用美国BD公司BACTEC9050型全自动细菌分析仪对血培养标本进行鉴定,法国梅里埃公司VITEK-2COMPACT全自动微生物鉴定仪鉴定细菌菌种,K-B琼脂纸片扩散法测定分离菌对常用抗菌药物的敏感性。结果共收集临床血培养标本3 360份,血培养阳性416份,其中细菌标本407份,占97.84%;真菌标本9份,占2.16%。血培养阳性标本主要采自10个临床科室,以内科标本数量最多(占34.13%)。共分离出革兰阳性菌232株(占55.77%),革兰阴性菌175株(占42.07%),真菌9株(占2.16%);其中表皮葡萄球菌142株(占34.13%),大肠埃希菌70株(占16.83%),肺炎克雷伯菌46株(占11.06%),金黄色葡萄球菌46株(占11.06%),铜绿假单胞菌19株(占4.57%)。凝固酶阴性葡萄球菌和金黄色葡萄球菌对青霉素和红霉素耐药率均>90.00%,肠球菌对红霉素的耐药率达到了100.00%,链球菌对青霉素和红霉素的耐药率均>70.00%,大肠埃希菌对哌拉西林耐药率最高,达82.86%,未发现对亚胺培南和美洛培南耐药的大肠埃希菌和肺炎克雷伯菌。铜绿假单胞菌对常用抗菌药物普遍较敏感。结论血培养病原菌以革兰阳性菌为主,今后应加强对可引起血液感染的细菌进行耐药监测,合理选择抗菌药物,及时控制血液感染。Objective To investigate the distribution of pathogenic bacteria and their drug resistance in positive blood culture specimens from inpatients of Jiangsu Shengze Hospital in 2012-2014,in order to provide reference basis for formulating the prevention and control measures of blood infection. Methods BACTEC 9050system（BD,USA）was used to identify blood culture specimens,VITEK-2COMPACT system（BioMerieux,France）for identifying the bacteria strains and K-B disc agar diffusion for sensitivities of the separated bacteria to commonly used antimicrobial agents. Results A total of 3,360 blood culture specimens were collected from the clinical,among which 416 specimens were positive,including 407 bacterial specimens,accounting for 97.84%,and 9fungal specimens,accounting for 2.16%.Positive blood culture specimens were mainly originated from 10 clinical departments,given priority to the internal medicine（34.13%）.Among the separated strains,232 strains were gram-positive bacterium（55.77%）,175 strains of gram-negative bacteria（42.07%）,and 9strains of fungi（2.16%）.Among them,there were 142 strains of staphylococcus epidermidis（34.13%）,70 strains of escherichia coli（16.83%）,46 strains of klebsiella pneumoniae（11.06%）,46 strains of staphylococcus aureus（11.06%）,and 19 strains of pseudomonas aeruginosa（4.57%）.Resistant rates of coagulase negative staphylococcus and staphylococcus aureus to penicillin and erythromycin were both larger than 90.00%,resistant rate of enterococcus to erythromycin was as high as 100.00%,and resistant rates of streptococcus to penicillin and erythromycin were both larger than 70.00%.Escherichia coli had the highest resistant rate（82.86%）to piperacillin,and escherichia coli and klebsiella pneumonia resistant to imipenem and meropenem were failed to find.In addition,pseudomonas aeruginosa was sensitive to most commonly used antimicrobial agents. Conclusion Blood culture pathogens are given priority to gram-positive bacterium.Monitoring on drug resistance of bac

关 键 词：血培养 病原菌 耐药性 血液感染 

分 类 号：R378[医药卫生—病原生物学]