81例败血症患者致病菌及其耐药特性分析

目的：探讨近年来败血症患者病原菌及其耐药特性。方法：对1997年1月～1999年12月在我院诊断败血症住院患者进行回顾性调查并根据医院感染诊断标准进行分组分析。结果：3年间诊断败血症患者共81例，共培养获得病原菌86株，其中院外组有62株，院内组24株，在院外组中,G^-菌37株（59.7%），G^ 菌20株（32.3%），真菌5株（8.1%），院内组G^-菌17株（70.8%），G^ 菌2株（8.1%），真菌5株(20.8%），在院外组中，前4位致病菌依次为沙门菌属、葡萄球菌、大肠埃希菌和白色珠菌，院内组中前4位依次为大肠埃希菌，不动杆菌属、白色念珠菌和耐甲氧西林葡萄球菌。有多种抗生素对院外组中的G^-菌具有较强抗菌活性，院内组致病菌均呈多重耐药特性。结论：G^-菌为败血症主要致病菌，院内获得性败血症致病菌呈多重耐药特性，了解本科室常见致病菌谱及其耐药特性对败血症治疗具有指导意义。

CHARACTERISTICS OF PATHOGENS SPETRUM AND DRUGS RESISTANCE IN 81 BACTE REMIC PATIENTS

Objective:To study the characteristics of pathogens spectrum and drugs resistance from bacteremic patients .Methods:From Janerary 1997 to December 1999,the records of bacteremic patients were retrospectively investigated and grouped according to the diagnostic creteria of nosocomial infection.Results:There were 81 patients with bacteremia in three years and 86 strans of pathogen isolated from them.There were 64 strans from community acquired bacteremic group(CBP)and 24 strans from nosocomial bacteremic group(NBP).There were 37 strans of Gram negative organism(G ,59.7%),20 trans of Gram positive organisms (G +,32.3%)and 5 strans of fungi(8.1%)in CBP,and 17 strans of G (70.8%),2 trans of G +(8.3%)and 5 strans of fungi(20.8%)in NBP.The first four pathogens of CBP was Salmonella,Staphyloccus,Escherichia coli and Candida albicans,otherwise it was Escherichia coli,Acinetobacter,Candida albicans and Methicillin resistant Staphyloccus of NBP.Many kinds of antibiotics had good activity against G in CBP.The pathogens of NBP were all in multiresistance.Conclusion:G was the main pathogen of bacteremia.The pathogens of NBP were all in multiresistance.To guide the therapy ,it is important to get knowledge of the characteristics of pathogens spetrum and drugs resistance in bacteremic patiens from your own department.