败血症100例致病菌及耐药性分析  

Analysis of Causative Bacteria and Resistance to Antibiotics in 100 Cases with Septicemia

作　　者：邢铭友[1] 丁红芳[1] 黄元成[1] 田德英[1] 宋佩辉[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院,武汉430030

出　　处：《内科急危重症杂志》2003年第1期6-9,共4页Journal of Critical Care In Internal Medicine

摘　　要：目的 :了解败血症患者致病菌及对常用抗生素的耐药情况。方法 :对我院近 3年以败血症为主要出院诊断且血培养阳性的患者进行回顾性分析 ,调查其致病菌及药敏情况 ,并进行统计。结果 :10 0例败血症患者血培养共检出细菌 10 7株 ,革兰阳性 (G+)球菌 61株 ,占 5 7.0 % ,其中金黄色葡萄球菌 3 8株 ,占 3 5 .5 % ,耐甲氧西林的金葡菌 (MRSA) 12株 ,占 11.2 % ;革兰阴性 (G-)杆菌 44株 ,占 41.1% ,其中大肠艾希菌 14株 ,占 13 .1% ;真菌败血症 2例 ,占 1.9%。结论 :G+球菌中MR SA、耐甲氧西林的凝固酶阴性葡萄球菌耐药情况严重 ;产超广谱 β 内酰胺酶的大肠艾希菌和肺炎克雷伯菌耐药性增加。G-杆菌败血症应用亚胺培南治疗者疗效优于其他抗生素 。Objective: To study the causative bacteria and the incidence of resistance to commonly used antibiotics in patients with septicemia. Methods: 100 patients with positive blood cultures and diagnosed as septicemia when discharged from hospital in last 3 years were analysed retrospectively. The causative bacteria and the drug sensitivity were investigated. Results: 107 strains of microorganisms were isolated from blood cultures of 100 septic patients, 61 strains( 57.0%) were gram positive, of which 38 strains ( 35.5%) were staphylococcus aureus, 12 strains ( 11.2%) of staphylococcus aureus were resistant to Oxacillin. 44 ( 41.1%) strains were gram negative, 14 ( 13.1%) strains were E.coli. 2 cases were fungus septicemia. Conclusions: MRSA and MRCNS were seriously resistant to most of the antibiotics. E.coli and Klebsiella with ESBLs showed more drug resistance. Bacillus septicemia treated with Imipenem showed better response than to the others, the therapeutic scheme named “De-Escalation” should be propagated.

关 键 词：败血症 致病菌 耐药性 降阶梯治疗 

分 类 号：R515.3[医药卫生—内科学]