外科血培养标本中病原菌分布及耐药性分析

目的了解中山大学附属第一医院外科血标本中病原菌的菌种分布及常见菌株的耐药性。方法血标本用Bact/A lert-120全自动血培养仪进行血培养,阳性血培养转种后用VITEK-60 AMS细菌鉴定仪鉴定,用K-B法进行药敏试验。结果2002年1月至2005年12月血培养标本中共分离出病原菌256株,阳性率为10.6%。122株(47.7%)为革兰阴性杆菌,其中肠杆菌科细菌占72.1%(88/122),非发酵菌占27.9%(34/122);113株(44.1%)为革兰阳性球菌,其中葡萄球菌属占51.3%(58/113),肠球菌占38.1%(43/113);真菌21株(8.2%)。血培养中的革兰阴性杆菌对亚胺培南、美洛培南治疗敏感;革兰阳性球菌对万古霉素和替考拉宁敏感。结论肠杆菌科细菌和葡萄球菌是外科血培养中的主要病原菌,其耐药现象严重,宜根据药敏结果选用敏感抗菌药物治疗。

Distribution and antibiotic resistance of pathogenic bacteria isolated from blood culture samples in surgery

Objective To analyze the distribution and antibiotic resistance of isolates from blood culture samples in surgery.Methods Blood cultures were detected by Bact/Alert-120 automated hemanalysis system,the positive blood cultures were identified with Vitek-60 instrument and bacterial susceptibility testing was conducted using K-B method.Results 256 strains of bacteria were isolated,positive rate was 10.6% from Jan.2002 to Dec.2004.Among all the 256 isolates,47.7%(n=122) were Gram-negtive bacilli,Enterobacteriaceae accounted for 72.1%(88/122) and non-fermentative species accounted for 27.9%(34/122);44.1%(n=113) were Gram-positive cocci,Staphylococcus spp.accounted for 51.3%(58/113) and Enterococcus accounted for 38.1%(43/113);8.2%(n=21) were fungi.Bacterial susceptibility testing suggested that Gram-negative bacilli were more sensitive to Imipenem and Meropenem;Gram-positive cocci were sensitive to Vancomycin and Teicoplanin.Conclusions Enterrobacteriaecae and Staphylococcus spp. were dominant in blood infection and the drug resistance is serious.The drugs should be chosen according to the results of the antimicrobial susceptibility tests.