河南省中医院血培养分离菌的分布及耐药性分析  

Distribution and antibiotic resistance of the microorganisms isolated from bloodstream

作　　者：胡玥[1] 张小倩[1] 李永伟[1] 

机构地区：[1]河南省中医院检验科微生物室,郑州450002

出　　处：《中国感染与化疗杂志》2016年第4期468-472,共5页Chinese Journal of Infection and Chemotherapy

基　　金：河南省教育厅科学技术重点项目(14A320028)

摘　　要：目的了解河南省中医院近年来血培养阳性标本中分离菌的分布及耐药性,为临床合理选择用药提供依据。方法回顾性分析2012年1月—2014年12月该医院各科室送检的血培养阳性结果,药敏数据用WHONET 5.6软件进行分析。结果共收集住院患者血培养标本3 634份,培养阳性291份,阳性率为8.0%。291份阳性标本中,革兰阳性菌139株,占47.8%;革兰阴性菌120株,占41.2%;真菌32株,占11.0%。139株革兰阳性菌中前3位的是凝固酶阴性葡萄球菌(72株)、金黄色葡萄球菌(34株)和肠球菌属(21株);120株革兰阴性菌前3位的是大肠埃希菌(54株)、铜绿假单胞菌(28株)和肺炎克雷伯菌(25株);32株真菌中前3位的是近平滑念珠菌(14株)、白念珠菌(10株)和季也蒙念珠菌(5株)。未发现耐万古霉素和利奈唑胺的葡萄球菌和肠球菌。结论临床医师应高度重视并及时送检血培养,以便尽早确定病原菌,报告药敏结果,为临床医师提供准确的诊断与治疗依据,有效控制血流感染。Abstract To understand the distribution and antibiotic resistance of the microorganisms isolated from bloodstream in Henan Province Hospital of TCM for rational antimicrobial therapy. Methods A retrospective analysis was conducted on the positive results of blood cultures of clinical specimens from January 2012 to December 2014. Antimicrobial susceptibility data were analyzed by WHONET 5.6 software. Results From January 2012 to December 2014, of the 3 634 blood samples submitted for culture of microorganisms, 291 （8.0 %） were positive, including 139 （47.8 %） strains of gram positive bacteria, 120 （41.2 %） strains of gram negative bacteria, and 32 （11.0 %） strains of fungi. The most common gram positive bacteria were coagulase-negative Staphylococcus （72 strains）, Staphylococcus aureus （34 strains）, and Enterococcus （21 strains）. The most common gram negative bacteria were Escherichia coli （54 strains）, Pseudomonas aeruginosa （28 strains）, and Klebsiella pneumoniae （25 strains）. The top three fungal species were Candida parapsilosis （14 strains）, Candida albicans （10 strains）, and Candida guilliermondii （5 strains）. Neither Enterococcus nor Staphylococcus strains were found resistant to vancomycin or linezolid. Conclusions Clinicians should pay more attention to blood culture and antimicrobial susceptibility testing for appropriate antimicrobial therapy and proper control of hospital infections.

关 键 词：血培养 病原菌 抗菌药物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]