血培养标本中病原菌分布及耐药性分析  

Distribution and drug resistance analysis of pathogens in blood culture specimen

作　　者：周婷婷[1] 茆海丰[2] 姜山[3] 金丹婷[2] 彭云飞 

机构地区：[1]南京医科大学康达学院病原免疫教研室,江苏连云港222006 [2]连云港市第一人民医院检验科,江苏连云港222002 [3]南京中医药大学连云港附属医院脑病科,江苏连云港222000 [4]连云港市急救中心急救科,江苏连云港222000

出　　处：《中华医院感染学杂志》2017年第19期4356-4358,4370,共4页Chinese Journal of Nosocomiology

基　　金：连云港市卫生计生委科技项目(1104)

摘　　要：目的分析医院血流感染主要病原菌种类及耐药性情况。方法对医院2014年1月-2016年12月送检标本的培养分离和药敏结果进行回顾性统计分析,统计致病菌的分布和药物敏感性。结果 2014年1月-2016年12月医院共送检21085份标本,阳性标本1661份,阳性率7.88%,共分离病原菌1 448株,其中革兰阳性菌796株占54.97%,革兰阴性菌611株占42.20%,真菌41株占2.83%;儿科病原菌所占比例最高占37.15%,其他依次为ICU占13.12%、感染性疾病科占7.60%、血液病科占4.70%;检出率较高的病原菌依次为凝固酶阴性葡萄球菌占35.64%、大肠埃希菌占16.85%、肺炎克雷伯菌占8.77%,未检出耐万古霉素、利奈唑胺、达托霉素的葡萄球菌,但对青霉素和红霉素高度耐药,大肠埃希菌对三代头孢菌素的耐药率高于60.00%,而对碳青霉烯类抗菌药耐药率低于5.00%,肺炎克雷伯菌对三代头孢菌素的耐药率高于40.00%,有高于10.00%对碳青霉烯类耐药。结论医院血流感染病原菌检出率低,病原菌构成多变,普遍存在耐药情况。因此了解血培养病原菌的分布及药敏情况,对临床合理用药有重要意义。OBJECTIVE To analyze the main pathogenic bacteria and drug resistance of hospital bloodstream infection.METHODS The cultured isolation and drug susceptibility results of the samples from Jan.2014 to Dec.2016 were retrospectively analyzed,and the distribution of pathogens and drug susceptibility were statistically analyzed.RESULTS In the past three years,21,085 samples were collected and tested,including 1661 positive samples,with a positive rate of 7.88%.Totally 1448 strains of pathogens were isolated,including 796 strains of gram-positive bacteria,accounting for 54.97%,611 strains of gram-negative bacteria,accounting for 42.20%and 41 strains of fungi,accounting for 2.83%.The highest proportion of pathogens was pediatrics,accounting for 37.15%,and then followed by ICU（13.12%）,infectious diseases department（7.60%）,and blood diseases department（4.70%）.The pathogens with high detection rate were coagulase-negative Staphylococci（35.64%）,Escherichia coli（16.85%）,and Klebsiella pneumoniae（8.77%）.No Staphylococci were found resistant to vancomycin,linezolid,or daptomycin.It was highly resistant to penicillin and erythromycin.The resistant rate of E.coli to the third-generation cephalosporins was higher than 60.00%,to carbapenem was less than 5.00%.The resistant rate of K.pneumoniae to the third-generation cephalosporin was higher than 40.00%,in which more than 10.00%was resistant to carbapenems.CONCLUSIONThe detection rate of pathogens in hospital bloodstream infections is low,the pathogenic bacteria are variable,and the prevalence of drug resistance is widespread.Therefore,it is great significance to understand the distribution and drug sensitivity of pathogenic bacteria in blood culture,in the meanwhile,providing the basis for clinical rational drug use.

关 键 词：病原菌 血培养 耐药性 

分 类 号：R446.5[医药卫生—诊断学]