老年血培养阳性患者病原菌分布及耐药性分析  

Distribution and antibiotic resistance of the pathogens isolated from elderly patients with positive blood cultures

作　　者：陈梦楠[1] 赵小芹[1] 卢斌[1] 李璐[1] 邓丽华[2] 杨荣胜[2] 李雷[3] 杨荣礼[3] 

机构地区：[1]徐州医学院研究生学院,江苏徐州221004 [2]徐州医学院附属医院检验科,江苏徐州221002 [3]徐州医学院附属医院老年医学科

出　　处：《徐州医学院学报》2016年第3期199-202,共4页Acta Academiae Medicinae Xuzhou

摘　　要：目的：分析老年血培养阳性患者的病原菌分布及耐药性，为临床抗菌药物的合理选择提供依据。方法对833例老年血培养阳性患者的病原菌以及药敏试验结果进行回顾性分析。结果共分离出1023株病原菌，其中革兰阳性菌株539株（52．7％），前三位为凝固酶阴性葡萄球菌、金黄色葡萄球菌和粪肠球菌；革兰阴性菌448株（43．8％），前三位为大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌；真菌36株（3．5％），以白色假丝酵母菌和都柏林假丝酵母菌为主。致病菌入侵的主要途径为呼吸系统、胆系、泌尿系。耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）和耐甲氧西林金黄色葡萄球菌（MRSA）的检出率分别为79．1％（291／368）和68．0％（66／97）。结论老年血流感染患者感染途径以呼吸道为主，常见的病原菌为革兰阳性菌且其耐药性较高。尽早行病原菌及耐药性检测有利于指导临床进行合理治疗。Objective To analyze the distribution and antibiotic resistance of the pathogens isolated from elderly patients with positive blood cultures, so as to provide evidence for rational use of antimicrobial drugs in clinical practice .Methods A total of 833 elderly patients were enrolled into the current study.Their clinical data about pathogens and drug sensitivity test were retrospectively analyzed.Results A total of 1 023 strains of pathogens were isolated, including 539 （52.7%） strains of gram-positive bacteria.The top three bacteria were coagulase-negative staphylococci, Staphylococcus aureus, Enterococcus faecalis.There were 448 （43.8%） strains of gram-negative bacteria, the top three of which were Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii.There were also 36 （3.5%） strains of fungi which mainly included Candida albicans and Candida dubliniensis.The mainly route of pathogenic invasion were the respiratory system , biliary tract, and urinary tract. The detection rates of MRCNS and MRSA were 79.2% （294/371） and 68.0% （66/97）, respectively.Conclusion The mainly route of pathogenic invasion were the respiratory system .The most common pathogens were gram-positive bacteria with high resistance.It is necessary to undergo pathogen detection and drug resistance testing.

关 键 词：老年人 血培养 病原菌 耐药性 

分 类 号：R117[医药卫生—公共卫生与预防医学]