血液或无菌体液培养阳性标本中病原菌检测结果分析

目的：了解血培养（包括血液、无菌体液培养，下同）阳性标本中病原菌的分布及阳性报警时间，为临床及时明确病原菌和正确用药提供参考依据。方法：无菌条件下采集血培养标本注人相应的培养瓶，经仪器扫描后放入血培养仪进行检测，报警后及时进行菌种鉴定和药敏试验。结果：364例阳性报警标本中真阳性标本为176例，其中革兰阳性菌占61．7％，革兰阴性菌占35．0％，真菌占3．3％；188例为假阳性标本，其中革兰阳性菌占54％，革兰阴性菌占41．9％，真菌占4．0％；新生儿科的感染阳性率最高；不同种类病原菌的阳性报警时间多重叠；临床医生经验用药正确或根据药敏结果更换用药的百分比为78．2％。结论：本院引起血液、无菌体液感染的病原菌以革兰阳性细菌为主，病原菌种类较多，存在一定的污染；当新生儿有局部感染时要警惕脓毒血症；单独靠血培养仪报警时间来鉴定区分病原菌与污染菌不一定可靠，及时了解血培养结果及标准药敏结果可以辅助找出感染性疾病的病因，尽早正确合理的使用抗菌药物，从而优化抗菌治疗。

Analysis of the Pathogen Detection Results of Positive Blood Sterile Fluid Cultures

Objective： To investigate the bacterium distribution and pathogenic positive alarm time of the positive blood culture （including sterile body fluid culture, similarly hereinafter） samples, and provide the basis for timely clinical pathogens clarification, and correct clinical medication. Methods： Aseptic collection of blood or sterile body fluid specimens were injected corresponding culture bottle, and were examined by the apparatus scans, then placed into culture instrument for detection, and alarm timely identification and drug sensitive test. Results： Positive alarm strains were of 364 cases, 176 cases of blood or sterile fluid infection were confirmed, which accounted for 61.7% of Gram-positive bacteria, Gram-negative bacteria accounted for 35.0%, fungi 3.3%.188 cases of false positive 2） specimens, which accounted for 54% of Gram-positive bacteria, Gram-negative bacteria accounted for 41.9%, fungi 4%; the infection of the highest is neonatus; positive alarm time of different kinds of the pathogen is overlap; clinical doctors experience right according to antimicrobial susceptibility results change the use of drug percentage is 78.2%. Conclusion： The blood, sterile fluid infection was caused mainly by various types of pathogens in Gram-positive bacteria, and there were certain pollution; baby was a partial to be wary of sepsis infection; by the blood culture alarm time to identify and distinguish the pathogen were not necessary, thus timely understanding of blood culture results, selecting sensitive drugs for medication could effectively improve the blood, sterile fluid infection cure rate.