某三甲医院近5年血培养分离菌的分布及药敏谱分析  

Distribution and drug sensitivity analysis of blood cultures isolated nearly five years from a three grade hospital

作　　者：张立平 舍燕[3] 刘波 丁风琴 邓丽 朴文花 

机构地区：[1]宁夏人民医院临床医学检验诊断中心,宁夏银川750002 [2]西北民族大学第一附属医院检验科,宁夏银川750002 [3]宁夏迪安乐嘉医学检验中心,宁夏银川750002 [4]西北民族大学,甘肃兰州730030

出　　处：《宁夏医学杂志》2018年第2期123-126,共4页Ningxia Medical Journal

基　　金：宁夏自然科学基金资助项目(NZ16195)

摘　　要：目的通过分析血培养分离病原菌的分布特征及细菌对常用抗生素的耐药情况,为临床预防和诊疗血流感染提供依据。方法对宁夏人民医院2012年1月-2016年12月血培养的标本进行回顾性分析,并对分离的主要病原菌采用K-B或MIC法进行药敏试验,使用WHONET 5.6软件对病原菌的分布和药敏结果进行分析。结果 2012年1月-2016年12月血培养标本中分离出病原菌1 811株,其中革兰氏阴性菌955株(52.73%),革兰氏阳性菌720株(39.76%),真菌31株(1.71%)。凝固酶阴性葡萄球菌(CNS)分离率最高,为432株(23.85%),其次为大肠埃希菌371株(20.49%)、布鲁菌属262株(14.47%)、克雷伯菌128株(7.07%)、金黄色葡萄球菌101株(5.58%)。重症医学科(ICU)、儿科、感染科血培养的阳性率最高,检出了对碳青霉烯类药物耐药的肠杆菌科细菌,耐甲氧西林金黄色葡萄球菌(MRSA)检出率为25.3%,未发现对万古霉素、替考拉宁、利奈唑胺耐药葡萄球菌,检出了对万古霉素耐药的肠球菌。结论此院血培养分离的病原菌分布广泛,对抗菌药物的耐药性严重,临床医师应提高血培养送检率、合格率,动态监测细菌的耐药性,同时应重视高发的布鲁菌引起的血流感染。Objective To analyze the distribution and drug resistance of pathogen bacteria in blood cuhures and to provide basis for clinical prevention and diagnosis and treatment of blood flow infection. Methods A retrospective analysis was conducted on blood culture specimens from clinical lab of Ningxia People＇ s Hospital between January 2012 and December 2016. The antimicrobial sensitivi- ty of isolates was detected by K - B method and MIC method. The distribution of pathogens and drug susceptibility were statistically ana- lyzed by WHONETS. 6 software, Results 1811 clinical isolates were collected from blood culture specimens between January 2012 and December 2016, Specifically, with 955 strains of gram - negative bacteria （52.7%）, 720 strains of gram - positive bacteria （39.8%）, 31 strains of fungi （1.7%）, Coagulation enzyme -negative staphylococcus （CNS） was the most frequently isolated 432 （23.9%）, fol- lowed by Escherichia coli 371 strains （20.5%）, Brucella 262 strains （ 14.5% ）, Klebsiella 128 （7.1%）, Staphylococcus aureus 101 （5.6%）. Positive rate of blood culture specimens from ICU, Pediatric Dwpartment and Infectious Dwpartment was the highest. The ex- istent resistance rates of Enterobacteriaceae bacteria to Carbapenems. The detection rate of methicillin - resistant Staphylococcus aureus （MRSA） was 25.3%, No resistant to vancomycin, teicoplanin, Linezolid resistant Staphylococcus. Vancomycin -resistant Enterococ- cus detected. Conclusion The pathogen bacteria isolated from blood culture specimens from our hospital is widely distributed, the drug resistance of antimicrobial drugs is serious, the clinical examination should improve the qualified rate of blood culture specimens, moni- tor the bacterial resistance dynamically and focus on regional high incidence of Brucella caused by bloodstream infection.

关 键 词：血培养 病原菌 耐药性 血流感染 

分 类 号：R446.5[医药卫生—诊断学]