不同病区血培养病原菌分布及耐药性分析

目的 了解各病区血培养分离病原菌的分布特点及其耐药性,指导临床医生合理有效地使用抗生素.方法 对宁波市泌尿肾病医院·鄞州第二医院2008年8月至2011年7月临床送检的8409例血液标本经Bact/A-lert3D全自动血培养仪培养,分离所得菌用美国德灵公司Walkaway 40系统进行鉴定和药敏.对检测结果进行统计学分析.结果 共检出病原菌853株,其中革兰阴性杆菌422株,革兰阳性球菌396株,真菌35株.血浆凝固酶阴性葡萄球菌占首位,其次分别为大肠埃希菌及肺炎克雷伯菌.检出菌数量居前三位的病区是重症监护病房、消化内科及肾内科.各病区的病原菌分布不尽相同.丁胺卡那、亚胺培南对大肠埃希菌、肺炎克雷伯菌显示出较高的敏感性,未发现耐利奈唑胺及万古霉素菌株.结论 该院血流感染病原菌以革兰阴性杆菌为主,各主要病区病原菌分布不尽相同,临床医生应跟据药敏结果合理有效地使用抗生素.

The distribution and resistance of pathogenic bacteria in blood culture from different sickrooms

Objective To investigate the distribution of pathogens and drug resistance in blood culture from different sickrooms.Methods This investigation was conducted in patients from August 2008 to July 2011 in our hospital.Blood samples were cultivated with Bact/Alert3D automated hemanalysis system.Pathogenic bacteria were identified with Walkaway40.The results were analysed.Results A total of 853 strains of pathogens were isolated from the 8409 cases.Among them,422 Gram-negative bacilli(49.47%),396 Gram-positive cocci(46.42%) and 35 fungus(4.10%) were identified.Coagulase-negative staphylococci were the most common bacteria,followed by E.coli and Klebsiella pneumoniae.Most of the pathogenic bacteria were isolated from ICU,Digestive System Department and Urology Department.The distribution of pathogenic bacteria varied in different sickrooms.E.coli and Klebsiella pneumoniae were sensitive to imipenem and amikacin.No gram-positive cocci were resistant to linezolid and vancomycin.Conclusion Gram-negative bacilli are the major pathogens isolated from blood samples.The distribution of pathogenic bacteria varies in different sickrooms.Clinicians should pay more attention to monitoring of drug resistance to use antibiotics reasonably and effectively.