摘要
目的研究2011—2013年安徽医科大学解放军174临床学院血培养阳性标本的病原菌分布和耐药性变迁情况,为临床合理使用抗菌药物提供依据。方法收集血培养阳性菌株,细菌鉴定和药敏分析用微生物鉴定药敏测试系统96和梅里埃VITEK 2 Compact全自动细菌鉴定及药敏分析仪,按照美国临床实验室标准化组织(CLSI)2013标准判读结果。结果自6 687份血培养标本中共检出病原菌765株,阳性率为11.4%。其中,革兰阴性菌占54.2%,革兰阳性菌占42.6%,真菌占3.1%。病原菌主要为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌。药敏检测:万古霉素和利奈唑胺抗菌对革兰阳性菌抗菌活力最好,未发现耐药菌株;碳青霉烯类对大肠埃希菌和肺炎克雷伯菌抗菌活力最好,但鲍曼不动杆菌对其耐药率较高,多黏菌素B抗菌活力最好。结论该院患者血流感染的病原菌以革兰阴性菌较多,耐药现象严重。因此,应加强监测的分析,以指导临床合理用药物。
[Objective]To study the pathogen distribution and drug resistance changes of positive samples for blood culture in Chinese People＇s Liberation Army No.174 Clinical College of Anhui Medical University from 2011-2013,provide the basis for rational use of antimicrobial agents in clinic.[Methods]The positive strains from blood culture were collected.Bacterial identification and drug susceptibility analysis were performed by Microscan Walk Away 96 and VITEK 2 Compact.The results were interpreted according to CLSI 2013.[Results]Totally 765 strains of pathogens were isolated from 6 687 blood culture samples,with the positive rate of 11.4%,and gram-negative bacteria,gram-positive bacteria and fungi accounted for 54.2%,42.6%and 3.1%,respectively.The pathogens mainly included Escherichia coli,coagulase negative Staphylococcus,Klebsiella pneumoniae,Staphylococcus aureus and Pseudomonas aeruginosa.The drug susceptibility analysis showed that vancomycin and linezolid performed the best antibacterial activity to gram-positive bacteria,and no resistant strains were found.Carbapenems showed the best antibacterial activity on Escherichia coli and Klebsiella pneumoniae,but Acinetobacter baumannii isolates were highly resistant to it,while polymyxin B showed the lowest resistance to the bacteria.[Conclusion]Gram-negative bacteria were the major pathogens of blood-borne infections in this hospital,and the drug resistance to common drug is very serious.Therefore,it is necessary to strengthen the monitoring and analysis to guide clinical rational use of antibacterial drugs.
出处
《职业与健康》
CAS
2015年第23期3232-3235,共4页
Occupation and Health
基金
福建省科技计划项目(项目编号:2013D006)
厦门市科技创新项目(项目编号:3502Z20134024)
全军医学科技青年培育项目(项目编号:13QNP047)
关键词
血培养
病原菌
抗菌药物
耐药性
Blood culture
Pathogen
Antibiotic drug
Drug resistance
