1995-2001年上海地区部分医院血培养分离菌的分布及耐药性变迁

Distribution and Changing Pattern of Susceptibility of Blood Culture Isolates in Shanghai, 1995-2001

目的了解1995～2001年上海地区血培养分离菌的分布及耐药性变迁. 方法对上海地区11所医院1995年1月～2001年12月所有血标本按常规方法进行分离、培养、鉴定.按统一方案用Kirby-Bauer纸片扩散法进行抗菌药物敏感试验. 结果 1995～2001年血培养获分离菌4 006株,其中革兰阳性球菌占56.5%,革兰阴性杆菌占43.5%;最常见的分离菌分别为凝固酶阴性葡萄球菌(CNS)、大肠埃希菌、金黄色葡萄球菌、克雷伯菌属以及肠球菌属和伤寒沙门菌;1995～2001年血培养分离株中革兰阳性菌所占比例由44.4%增至53.1%;葡萄球菌及肠球菌中均未发现万古霉素耐药株;革兰阴性菌对碳青酶烯类高度敏感. 结论 1995～2001年革兰阳性菌,尤其是CNS在血液感染中占重要地位,血培养分离菌中革兰阳性菌所占比例增多明显;血培养分离株对常用抗菌药耐药明显.

OBJECTIVE To investingate the distribution and changing pattern of susceptibility of blood culture isolates in eleven Shanghai hospitals from 1995 through 2001. METHODS The blood specimens were routinely incubated, isolated, identified and their susceptibility against >20 antimicrobial agents was determined by Kirby-Bauer methods by the participating institutions. RESULTS A total of 4 006 strains were isolated, Gram positive cocci and Gram negative bacilli accounted for 56.5% and 43.5%, respectively. The most frequent isolates were coagulase negative Staphylococcus (CNS, 39.3%), Escherichia coli (12.1%), Klebsiella spp (7.3%), Staphylococcus aureus (9.5%) and Enterococcus spp (4.1%) and Salmonella typhii (4.1%). Gram positive cocci increased from 44% to 53% from 1995 through 2001. No strains resistant to vancomycin were found in staphylococci and enterococci.Gram negative bacilli were highly susceptible to carbapenem. CONCLUSIONS Gram positive cocci play an important role in blood stream infections, especilly CNS, and Gram positive cocci have been remarkablly increased from 1995 through 2001, resistance to the first line antibiotics is common among all blood isolates.