血培养阳性脓毒血症患者病原菌及药敏分析  

Analysis of pathogenic bacteria and drug sensitivity in sepsis patients with blood cultures positive

作　　者：杨芳[1] YANG Fang(Chengdu Fifth Peopled Hospital,Chengdu,China)

机构地区：[1]成都市第五人民医院,四川成都611130

出　　处：《实用医院临床杂志》2018年第5期133-135,共3页Practical Journal of Clinical Medicine

摘　　要：目的探讨成都第五人民医院重症医学病房(ICU)患者血培养阳性脓毒症的病原菌分布、药敏试验及耐药情况,为临床医师经验性使用抗菌药物提供参考依据。方法回顾性分析240例老年脓毒症患者感染特点及血培养阳性结果,分析病原菌分布特点、主要病原菌的药敏试验及耐药情况。结果本组革兰阴性菌160例(66.67%),革兰阳性菌60例(25%),真菌20例(8.33%);社区获得性感染例180例(75%),院内感染60例(25%)。药敏试验显示碳青霉烯类和阿米卡星对革兰阴性杆菌最为敏感,对革兰阳性球菌敏感性较高的药物为万古霉素及利奈唑胺,但有耐万古霉素的屎肠球菌8例。结论 ICU血培养阳性患者病原菌分布以革兰阴性菌为主,大肠埃希菌是最常见的病原菌,对碳青霉烯类抗生素仍最为敏感。Objective To investigate the distribution of pathogens and analyze its sensitive and resistance to main antimicrobial drugs in sepsis patients with blood culture positive at ICU department in our hospital in order to provide guidelines for clinical diagno-sis and treatment.Methods The characteristics of infection, positive results of blood culture, distribution of pathogenic bacteria, drug sensitivity test and drug resistance of main pathogens from 240 elderly sepsis patients were retrospectively analyzed.Results Of the patients,160 patients were infected with gram-negative bacteria （66. 67% ） ,60 with gram-positive bacteria （25% ） and 20 with fungi （8. 33% ） .Furthermore, 180 patients were community infection （75% ） and 60 were nosocomial septicemia （25% ） .The drug sensitiv-ity test showed that the gram-negative bacteria were sensitive to carbapenem antibiotics and amikacin while the gram-positive bacteria were sensitive to vancomycin and linezolid.However, there were 8 cases with staphylococcus infection were resistant to vancomycin.Conclusion In the present study, it is shown that gram-negative bacteria are the predominant pathogens of septicemia in ICU positive blood cultures in which E.coli is the most common pathogen.The pathogens are still very sensitive to carbapenem antibiotics.

关 键 词：脓毒症 血培养阳性 病原菌 药敏试验 耐药性 

分 类 号：R446.5[医药卫生—诊断学]