摘要
目的 回顾性分析我院四年来血培养的病原菌分布和耐药情况，为临床抗感染治疗提供最新依据，促进抗菌药物的合理使用。方法：收集我院2010年8月-2014年8月血培养标本2894份，对报阳分离株采用梅里埃Vitek—compact系统进行鉴定和药敏试验，折点参照美国2015年CLSI M10025指南执行。结果：2894例血培养共分离出391株，阳性率为13．5％，其中革兰阴性菌231株（占59．1％），革兰阳性菌150株（占38．4％），真菌10株（占2．5％）。大肠埃希菌和肺炎克雷伯菌产超广谱B内酰胺酶（ESBLs）阳性率分别为63．0%23．1％，未发现耐亚胺培南株。耐甲氧西林金黄色葡萄球菌（MRsA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）检出率分别为37．9%和67．0%。糖肽类抗菌药物和利奈唑胺对革兰阳性球菌高度敏感。结论：院血培养分离的病原菌种类多，耐药性差异较大，产ESBLs酶的大肠埃希菌和耐甲氧西林凝固酶阴性葡萄球菌的耐药株检出率均大于60％。
Objective The aim of this study was to retrospectively analyze the distribution and drug resistance of pathogenic bacteria in bloodculture specimens, provide the basis for clinical anti-infective therapy, and promote rational use of antimicrobials. Methods： In our hospital inAugust 2010 August -2014 blood culture specimens 2894, using the United States Bactec9050 BD blood culture instrument for culture, bloodculture instrument 5 d culture without bacterial growth, as a negative culture. On positive isolates by bioMerieux Vitek compact system foridentification and drug susceptibility testing, break point with reference to the implementation of the 2015 the United States CLSI M100 S25guide. Results： 391 strains were isolated, and the detection rate was 13.5%. Among which 231 strains （59.1%） were gram-negative bacteria,150 strains （38.4%） were gram-positive bacteria and 10 strains （2.5%） were fungi. The detection rates of E. Coli and Klebsiella pneumoniaproducing extended spectum 13 lactamase were 63.0% and 23.1%. None isolates were resistant to impenem. The positive rates of Methicillin-resistant staphylococcus aureus （MRSA）and Methicillin Resistant Coagulase-Negative Staphylococci （MRCNS） were 37.9% and 67.0%. Gram-positive bacteria were highly sensitive to the antimicrobials including sugar peptide and linezolid. Conclusion：The pathogens isolated from theblood culture specimens in our hospital varied a lot and the drug resistance rates differed greatly. It is obvious that E. Coli （ESBLs） andMRCNS accounted for more than 60.0%.
出处
《世界中医药》
CAS
2016年第B03期1165-1166,共2页
World Chinese Medicine
关键词
血培养
病原菌分布
耐药性
blood culture
pathogen distribution
drug resistance
