摘要
目的了解血培养中病原菌分布及其耐药性,为临床治疗提供参考依据。方法对收集的3462份血标本经BacT/Alert 3D全自动血培养仪进行血培养,阳性标本培养出病原菌后用VITEK-32全自动细菌鉴定仪进行鉴定,用K-B纸片法进行体外药敏试验。结果 3462份血标本共检出467株病原菌,检出率为13.49%;最多见的病原菌为凝固酶阴性葡萄球菌107株占22.91%,其次分别为大肠埃希菌88株占18.84%,肺炎克雷伯菌70株占14.99%;革兰阴性菌对亚胺培南敏感性最好,大肠埃希菌、肺炎克雷伯菌及沙门菌属对其耐药率均为0,对阿米卡星、头孢哌酮/舒巴坦和哌拉西林/他唑巴坦耐药率较低,为10.00%～25.00%,对磺胺甲噁唑/甲氧苄啶的耐药率>60.00%;革兰阳性菌敏感性最好的药物为替考拉宁、利奈唑胺和万古霉素,3种主要菌株对其耐药率均为0,凝固酶阴性葡萄球菌和金黄色葡萄球菌对利福平耐药率较低,为5.00%～10.00%,对左氧氟沙星、阿米卡星耐药率为20.00%～30.00%,对青霉素的耐药率>85.00%;肠球菌属对抗菌药物的耐药率普遍较高。结论临床应根据血培养药敏结果合理应用抗菌药物,减少耐药株的产生。
OBJECTIVE To investigate the distribution and drug resistance of pathogenic bacteria in blood culture and provide basis for clinical treatment.METHODS A total of 3462 blood samples were cultured by BacT/Alert 3D automated blood culture system,the pathogenic bacteria were identified by VITEK32 system and K-B method was used for the antibiotics susceptibility testing.RESULTS There were 467 strains of pathogens isolated from 3462 blood samples with the detection rate of 13.49%;coagulase-negative Staphylococci was the most common species,accounting for 1 22.91%（107 strains）,followed by 88 strains of Escherichia coli（18.84%）and 70 strains of Klebsiella pneumoniae（14.99%）;the results of drug susceptibility testing showed that gram-negative bacteria were most sensitive to imipenem,the drug resistance rates of E.coli,K.pneumonia and Salmonella were 0%,the drug resistance rates to amikacin,cefoperazone/sulbactam,and piperacillin/tazobactam ranged from 10.00% to 25.00%,the drug resistance rates to compound sulfamethoxazole were beyond 60.00%;gram-positive bacteria were most sensitive to teicoplanin,linezolid and vancomycin,the drug resistance rates of the three main species were all 0%,the drug resistance rates of coagulase-negative Staphylococci and Staphylococcus aureus to rifampicin varied from 5.00% to 10.00%,the drug resistance rates to levofloxacin and amikacin ranged from 20.00% to 30.00%,the resistance rates to penicillin were over 85.00%;Enterococci were highly resistant to antibiotics.CONCLUSION It is necessary to reasonably use antibiotics in accordance with the drug susceptibility testing of blood culture so as to reduce the drug resistant strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第24期5645-5647,共3页
Chinese Journal of Nosocomiology
关键词
血培养
病原菌
分布
耐药性
Blood culture
Pathogen
Distribution
Drug resistance
