血培养中病原菌的分布及其耐药状况分析

目的:了解血培养中病原菌的菌群分布及其耐药状况.方法:血培养标本用Bact/Alert-120自动血液分析系统和Vitek60鉴定仪进行血培养及鉴定,药敏用K-B法,用Whonet 5软件进行分析.结果:在3 680份血培养标本中分离出细菌348株,阳性检出率为9.4%,病原菌中以革兰阴性杆菌为主共分离出189株,占54.3%,其中主要为大肠埃希菌占15.5%,肺炎克雷伯菌占12.4%;革兰阳性菌138株,占39.7%,主要为凝固酶阴性葡萄球菌占14.9%,金黄色葡萄球菌占12.1%;链球菌占6.6%.血培养中的革兰阴性杆菌对亚胺培南、阿米卡星、头孢哌酮/舒巴坦治疗较为敏感:革兰阳性球菌对万古霉素和替考拉宁较为敏感.结论:肠杆菌科细菌和葡萄球菌是血培养中的主要病原菌,而产ESBLs菌株、MRSA、MRCNS耐药严重,提示应高度重视合理使用抗生素,减少细菌耐药性产生,以提高临床治疗效果.

The distribution and drug resistance analysis of pathogenic bacteria isolated from blood samples

Objective: To investigate distribution and drug resistance situation of pathogenic bacteria isolated from blood samples.Methods:Blood samples were cultivated with Bact/Alert-120 automated hemanalysis system and pathogenic bacteria were identified with Vitek60 instrument ,drug sensitivity tests used K-B method ,and test results were analyzed with Whonet 5 software.Results:Totally 348 strains of bacteria were isolated from 3 680 blood samples ,positive rate was 9.4%.189 strains of Gram-negtive bacilli were dominant in pathogenic bacteria accounted for 54.3%,among it Escherichia coli and Klibaiella pneumoniae accounted for 15.5%,12.4% respectively;138 strains of Gram-postitve cocci were isolated accounting for 39.7%,Staphylococcus Coagulase-negative and Staphylococcus aura and Streptococcus were diminant in Gram-positive cocci account for 14.9%,12.1%,6.6% respectively.Drug sensitivity tests suggested that Gram-negative bacilli were more sensitive to Imipenem and Amikacin,Cefoperazone/Sulbactam;Gram-positive cocci were sensitive to Vancomycin and Teicoplanin.Conclusion:Pathogenic bacteria of Enterrobacteriaecae and Staphylococcus aurus were dominant in blood infection.ESBLs producing strains and MRSA and MRCNS were resistant severely to antibiotics ,it suggested that antibiotics must be reasonably applied to reduce more and more resistant pathogeic bacteria to be produced and enhance clinical therapy effect.