血培养病原菌构成及耐药性分析

了解2008年至2012年哈尔滨医科大学附属第一医院血培养常见病原菌构成及耐药性。对血培养分离出的病原菌进行鉴定,用MIC法、K-B法测定药物敏感性,用WHONET 5.6统计软件进行细菌菌谱及耐药性分析。共分离出病原菌4 245株;其中凝固酶阴性葡萄球菌最多,947株占22.3%;其次为大肠埃希菌822株,肺炎克雷伯菌520株,鲍曼不动杆菌195株,金黄色葡萄球菌142株;耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)和耐甲氧西林金黄色葡萄球菌(MRSA)检出率分别为81.1%、38.8%,未发现耐万古霉素、利奈唑胺及替考拉宁的凝固酶阴性葡萄球菌和金黄色葡萄球菌;大肠埃希菌及肺炎克雷伯菌产ESBLs检出率分别为55.2%、53.8%,对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦、头孢替坦、头孢西丁、阿米卡星的耐药率较低,对碳青霉烯类抗菌药物存在耐药现象;鲍曼不动杆菌对抗菌药物的耐药率普遍较高。及时、准确地对血培养分离出的病原菌进行监测,以便指导临床合理用药,控制耐药株的产生。

Composition & Drug Resistance of Blood Culture Pathogens in the Hospital

Common pathogen composition and drug resistance of blood culture samples in the first affiliated hospital of Harbin Medical University from 2008 to 2012 was investigated. Pathogens of blood culture were identified. MIC test and Kirby Bauer disc diffusion test were used to detect the antimicrobial sensitivity. WHONET 5.6 statistic software was applied for analyzing the bacterial spectrum and drug resistance. A total of 4 245 strains of pathogens were isolated. Coagulase negative Staphylococcus was the most, 947 strains acounted for 22.3%, E. coli was the second, 822 strains, followed by Klebsiella pneumoniae, 520 strains, Acinetobacter baumannii, 195 strains, and Staphylococcus aureus, 142 strains. The detection rates of the MRCNS and MRSA of S. aureus were 81.1% and 38.8% respectively. MRCNS vancomycin, linezolid and teicoplanin resistant Staphylococcus and S. aureus were not found. The positive rates of ESBLs producing E. coli and K. pneumoniae were 55.2% and 53.8% respectively. The drug resistance rates to cefoperazone/sulbactam, piperacillin/tazobactam, cefotetan, cefoxitin, and amikacin were fairly low. There was also resistance in carbapenem antibiotics. The resistance rate of A. baumannii was generally high against antibiotics. Therefore, it is important to carry out monitor and inspect pathogenic bacteria in blood culture timely and accurately, in order to direct the rational use of antibiotics and to control the emergence of drug resistant strains.