1152例血培养病原菌分布及其耐药性分析

Analysis of Pathogens Distribution and Drug-resistance on 1,152 Blood Culture Positive Specimens

目的了解血培养中阳性标本的病原菌分布及药敏情况,为临床抗感染治疗提供依据。方法对我院2003-2005年送检的血培养标本所分离的细菌及药敏情况进行回顾性分析。结果1 152份血培养标本共检出细菌127株,革兰阳性菌(G+)97株(占76.38%),以葡萄球菌为主(占63.78%),其中金黄色葡萄球菌36株,凝固酶阴性葡萄球菌45株;革兰阴性菌30株(23.62%),主要为大肠埃希菌、沙门菌属和肺炎克雷伯菌;耐苯唑西林的金葡和凝固酶阴性葡萄球菌分别为72.22%和66.67%,对七种常用抗菌素耐药率均在50%以上;大肠杆菌和肺炎克雷伯菌的超广谱β—内酰胺酶(ESBLs)检出率分别36.36%,33.33%,其对大多数常用抗菌素均显示较高的耐药率(>45%)。结论血培养中葡萄球菌是极为重要的致病菌,但革兰阴性菌所引起的感染也不容忽视。抗生素耐药率高,且具有高耐药与多重耐药的特点,治疗需以药物监测为依据。

Objective To investigate the distribution and the drug resistance of pathogens from blood cultures, and to provide evidences for chinical anti infection treatment. Methods The pathogens and drug susceptibilities of 1,152 blood samples collected from the hospital during the period of 2003-2005 were retrospectively analyzed. Results Altogether 127 strains bacteria were isolated from 1,152 blood cultures, 97 strains （76.38 % ） were Gram positive, and the leading isolates were Staphyloccus, among them 36 strains were Staphyloccus aureus, 45 coagulase negative staphylococcus （CONS）; 30 strains were Gram negative bacteria （23.62%） and the most common Gram negative bacilli were Escherichia coli, Salmonella and K. peumoniae. The rates of oxacillin resistance Staphylococcus aureus and CONS were 72.22% and 66.67%, the other 7 antibiotics were resisted by oxacillin resistance staphylococcus and the rate was over 50 %. The positive rates of ESBLs produced by Escherichia coil and K. peumoniae were 36.36% and 33.33% respectively, and these isolates presented relative higher resistance rate （ 〉45 % ） for the most antibiotics. Conclusions The infections caused by Gram- negative bacilli should not be neglected though staphylococci are the major pathogens in the blood calture. The antibiotics resistant rate of all bacteria rises gradually, moreover, they show highly resistance and multiple drug resistance, and hence antibiotic therapy should be taken and monitored according to the detected results.