本院2015-2019年全血标本的菌谱分布及耐药情况  

Bacterial Spectrum Distribution and Drug Resistance of Whole Blood Samples from 2015 to 2019 in Our Hospital

作　　者：席向宇 王为民[1] 张瑞梅[1] 刘慧梅[1] 潘永[1] 成松[1] XI Xiangyu;WANG Weimin;ZHANG Ruimei;LIU Huimei;PAN Yong;CHENG Song(Xuzhou Infectious Disease Hospital,Xuzhou 221004,China)

机构地区：[1]徐州市传染病医院,江苏徐州221004

出　　处：《中外医学研究》2021年第7期170-173,共4页CHINESE AND FOREIGN MEDICAL RESEARCH

摘　　要：目的:了解血培养阳性致病菌分布及耐药情况,为抗生素合理使用提供理论依据。方法:收集笔者所在医院2015年1月-2019年12月的3959份全血标本,致病菌的培养鉴定和药敏试验采用法国梅里埃ATB自动细菌鉴定及药敏仪,所有菌株按照常规操作流程进行鉴定,细菌菌谱及耐药性分析用软件WHONET 5.6进行。结果:3959份全血标本中病原菌阳性检出254份,检出率为6.42%,其中2015年阳性检出率最高,随着年份增加,阳性检出率逐渐下降。检出致病微生物中革兰阳性球菌占64.96%,革兰阴性杆菌占29.53%,真菌占4.72%,厌氧菌占0.79%。革兰阳性球菌对红霉素、青霉素和苯唑西林有很高的耐药率,但均对万古霉素敏感,其次的敏感药物为呋喃妥因和米诺环素。革兰阴性杆菌对青霉素类和头孢类药物都有较高的耐药性,而亚胺培南和美罗培南则是比较好的敏感药物。结论:本院血培养致病菌以革兰阳性球菌为主,且耐药现象非常普遍,及时对血液致病菌进行耐药性监测对于临床合理使用抗生素有重要意义。Objective:To understand the distribution and drug resistance of positive pathogenic bacteria in blood culture,and to provide theoretical basis for rational use of antibiotics.Method:A total of 3959 whole blood samples were collected from the author’s hospital from January 2015 to December 2019,the French ATB automatic bacteria identification and drug sensitivity instrument was used for the culture identification and drug sensitivity test of pathogenic bacteria,all strains were identified according to the routine operating procedures,and the bacterial spectrum and drug resistance test were performed with software WHONET 5.6.Result:A total of 3959 blood samples were detected and 254 pathogenic strains were isolated,the positive rate was 6.42%,the positive detection rate was the highest in 2015,and decreased gradually with the increase of years.Among the pathogenic bacteria,Gram-positive cocci accounted for 64.96%,29.53%were Gram-negative bacilli,4.72%were fungi and 0.79%were anaerobic bacteria.Gram-positive cocci had high drug resistance rates to Erythromycin,Penicillin and Benzoxicillin,but they were all sensitive to Vancomycin,the next most sensitive drugs were Nitrofurantoin and Minocycline.Gram-negative bacilli were highly resistant to Penicillins and Cephalosporins,while Imipenem and Meropenem were sensitive drugs.Conclusion:Gram-positive cocci are the main pathogenic bacteria in blood culture in our hospital,and the drug resistance is very serious.It is very important to monitor the drug resistance of blood pathogenic bacteria for guiding the rational use of antibiotics in clinical.

关 键 词：血培养 致病菌 菌谱分布 耐药 

分 类 号：R446.5[医药卫生—诊断学]