摘要
目的:监测和分析本院近3年的血液培养中主要病原菌的分布和耐药性分析,为临床合理使用抗菌药物,提供科学依据。方法:收集本院2014年1月-2016年11月间送检的血培养标本19 092份,采用Bactec9120全自动血液培养仪进行培养,阳性标本分离菌株使用DL-96全自动微生物鉴定及药敏分析系统进行细菌鉴定及药敏分析。结果:血液培养标本共分离出1 207株病原菌,其中革兰阳性球菌647株,占53.6%;革兰阴性杆菌560株,占46.4%;二者比较差异有统计学意义(P=0.002);主要病原菌依次为金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌、肺炎克雷伯菌、嗜麦芽窄食单胞菌,分离率分别为24.6%、22.7%、12.7%、5.2%、4.4%。葡萄球菌对万古霉素、替考拉宁、利奈唑胺的耐药率均为0%;大肠埃希菌和肺炎克雷伯菌对亚胺培南、美罗培南、哌拉西林/他唑巴坦的耐药率较低,大肠埃希菌分别为:0%、0.4%、3.3%,肺炎克雷伯菌均为0%。结论:血液培养病原菌种类复杂,耐药性差异大,主要病原菌以革兰阳性球菌为主,应加强血培养的监测,为临床合理、规范使用抗菌药物提供依据,以减少多重耐药菌的产生。
Objective：To monitor and analyze the distribution and drug resistance of main pathogenic bacteria in blood culture of this hospital in the recent 3 years,so as to provide scientific basis for rational use of antibiotics in clinic.Methods：The blood culture specimens were collected in this hospital from January 2014 to November 2016,which were cultured by Bactec9120 automatic blood culture instrument,and the positive separated specimens which were used for identification and antimicrobial susceptibility analysis of bacteria were analyzed by DL-96 automatic microbial strains.Results：A total of 1207 strains of pathogenic bacteria were isolated from blood culture specimens,of which 647 were gram-positive cocci,accounting for 53.6%,and 560 were gram negative bacilli,accounting for 46.4%.The Pvalue was0.002,which indicated a statistical significance.The main pathogens were Staphylococcus aureus,Escherichia coli,Staphylococcus epidermidis,Klebsiella pneumoniae and Stenotrophomonas maltophilia,the isolation rates were 24.6%,22.7%,12.7%,5.2%and 4.4%.The drug resistance rate of Staphylococcus to vancomycin,teicoplanin and linezolid was 0%,the drug resistance rate of Escherichia coli and Klebsiella pneumoniae to imipenem,meropenem,piperacillin/tazobactam was at a low level,while Escherichia coli was 0%,0.4%,3.3%and Klebsiella pneumoniae was 0%.Conclusion：The kinds of pathogens in blood culture are complex,drug resistance is different,the main pathogens of gram positive cocci,we should strengthen the monitoring of blood culture,so as to provide the basis for clinical reasonable use of antimicrobial drugs,and reduce the generation of multi drug resistant bacteria.
出处
《医学理论与实践》
2018年第3期329-331,共3页
The Journal of Medical Theory and Practice
关键词
血液培养
病原菌
耐药性
Blood culture,Pathogenic bacteria,Drug resistance
