肾病患者血培养标本病原菌分布及其耐药性分析  

Distribution and antibiotic resistance of pathogens isolated from blood cultures in patients with renal disease

作　　者：胡笛[1] 闫涛[1] 钱香[1] 楼正青[1] HU Di YAN Tao QIAN Xiang LOU Zheng- qing(Clinical Laboratory, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310007, China)

机构地区：[1]杭州市中医院检验科,浙江杭州310007

出　　处：《中国卫生检验杂志》2016年第23期3484-3486,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的分析肾病患者血培养阳性病原菌的分布和耐药性,指导临床合理用药。方法对某医院2014年-2015年肾内科住院患者血培养阳性病原菌分布及药敏结果进行回顾性分析。结果 1 052份血培养标本中共分离出病原菌111株,总阳性率为10.5%,其中革兰阴性菌41株,占36.9%;革兰阳性菌62株,占55.9%;真菌8株,占7.2%。革兰阴性菌中检出率前3位分别是大肠埃希菌(16.2%)、肺炎克雷伯菌(9.9%)和铜绿假单胞菌(6.3%);革兰阳性菌中检出率最高的是金黄色葡萄球菌(28.8%)和凝固酶阴性葡萄球菌(20.7%);真菌检出率最高的分别是白色假丝酵母菌(3.6%)和光滑假丝酵母菌(1.8%)。大肠埃希菌和肺炎克雷伯菌对亚胺培南最为敏感;葡萄球菌对万古霉素、利奈唑胺、喹奴普汀-达福普汀、替加环素均敏感。结论临床应根据病原菌变化及耐药性及时调整抗菌药物。Objective To analyze the distribution and drug-resistance of positive pathogens from blood culture in renal disease patients,so as to provide reference for clinical rational use of antibiotics. Methods To retrospectively analyze the distribution and antibiotic sensitivity of positive pathogen isolates from blood culture in patients with renal disease in the hospital during2014-2015. Results 111 pathogens were isolated from 1 052 blood culture samples,with the positive rate of 10. 5%,among which 41 strains（ 36. 9%） were gram-negative bacilli,62 strains（ 55. 9%） were gram-positive bacilli,8 strains（ 7. 2%）were fungus. The gram-negative bacilli with top 3 highest isolation rates were E. coil（ 16. 2%）,followed by Klebsiella pneumoniae（ 9. 9%） and Pseudomonas aeruginosa（ 6. 3%）. The gram-positive bacilli with the highest isolation rate were Staphylococcus aureus（ 28. 8%）,Coagulase-negative staphylococcus（ 20. 7%）. The fungus with the highest isolation rate were Candida albicans（ 3. 6%）,C. tropicalis（ 1. 8%）. Escherichia coli and Klebsiella pneumoniae were most sensitive to imipenem; Staphylococcus aureus was sensitive to vancomycin,Linezolid,quinupristin-dalfopristin and Tigecycline. Conclusion Clinicians should adjust antibiotics in time by pathogens and drug resistance.

关 键 词：肾病 血培养 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]