2018年陕西省人民医院全自动血培养仪及配套鉴定系统分离病原菌的实验室特征及耐药率分析  

Laboratory Characteristics and Drug Resistance Analysis of Pathogenic Bacteria Isolated by Automatic Blood Culture Instrument and Matching Idetification System in Shaanxi Provincial People’s Hospital in 2018

作　　者：关佳灏 赵海[2] 王翠 马娟[2] 张利侠[2] GUAN Jia-hao;ZHAO Hai;WANG Cui;MA Juan;ZHANG Li-xia(Xi’an Medical College,Xi’an 710021,China;Department of Clinial Laboratory,Shaanxi Provincial People’s Hospital,Xi’an 710068,China)

机构地区：[1]西安医学院,西安710021 [2]陕西省人民医院检验科,西安710068

出　　处：《现代检验医学杂志》2019年第6期113-117,共5页Journal of Modern Laboratory Medicine

摘　　要：目的分析2018年陕西省人民医院全自动血培养仪及配套鉴定系统分离病原菌的实验室特征及耐药率分析,为临床合理用药提供参考。方法对2018年陕西省人民医院临床送检的血培养标本中病原菌的分布及耐药率进行回顾分析。结果血标本培养的阳性率为9.92%,共分离病原菌962株,革兰阴性菌598株、革兰阳性菌354株、真菌10株;其中革兰阴性菌主要为大肠埃希菌占23.0%(221/962)和肺炎克雷伯菌占18.3%(176/962);革兰阳性菌主要为表皮葡萄球菌占10.2%(98/962)和人葡萄球菌占8.5%(82/962);真菌主要为白假丝酵母菌占0.6%(6/962)和近平滑假丝酵母菌占0.4%(4/962)。血培养阳性率较高的科室分别为肝胆外科、急诊外科、血液内科、重症医学科和呼吸内科。大肠埃希菌和肺炎克雷伯菌对亚胺培南和美罗培南的敏感率为98.2%;葡萄球菌属对万古霉素、利奈唑胺和替加环素的敏感率为100%。结论血流感染病原菌主要为革兰阴性菌,其对常用抗生素耐药率较高。临床应重视血培养标本的送检情况和细菌耐药监测,合理使用抗生素,早期控制血流感染,降低患者的病死率。Objective To analysis the distribution and drug resistance of pathogenic bacteria isolated by automatic blood culture instrument and matching identification system in Shaanxi Provincial People’s Hospital in 2018,and provide reference for clinical and rational use.Methods The distribution and drug resistance rate of pathogenic bacteria in blood culture collected from the Shaanxi Provincial People’s Hospital in 2018 were reviewed and analyzed.Results The positive rate of blood sample culture was 9.92%,a total of 962 strains of pathogenic bacteria were isolated,in which 598 strains of Gram-negative bacteria,354 strains of Gram-positive bacteria and 10 strains of the fungi.Among them,Gram-negative bacteria were mainly for Escherichia coli accounts was 23.0%(221/962),and Klebsiella pneumoniae accounts for 18.3%(176/962).Among them,Gram-positive bacteria mainly for Staphylococcus epidermidis accounts was 10.2%(98/962)and Staphylococcus human accounts for 8.5%(82/962).The fungi mainly for Candida albicans accounts was 0.6%(6/962)and Candida tropicalis accounts was 0.4%(4/962).The departments with high positive rate of blood culture were Hepatobiliary Surgery,Emergency Surgery,Hematology Department,Severe Medical Science and Respiratory Medicine Department,respectively.The sensitivity rate of Escherichia coli and Klebsiella pneumoniae to Imipenem and Meropenem were 98.2%,respectively.The sensitivity rate of Staphylococcus to vancomycin,linazolamine and tegacycline was 100%,respectively.Conclusion The main pathogen of blood flow infection was Gram negative bacteria,the resistance rate to common antibiotics was high.Clinical attention should be paid to the delivery of blood culture specimens and the monitoring of bacterial drug resistance,rational use of antibiotics,early control of blood flow infection,reduce the mortality of patients.blood flow infection and the early treatment of blood flow in clinic,reduce mortality from blood flow infection.

关 键 词：血流感染 耐药性 抗生素 药敏试验 

分 类 号：R378[医药卫生—病原生物学] R446.5[医药卫生—基础医学]