血培养中细菌的分布及耐药分析

Pathogentic bacteria of blood culture:their distribution and resistance

目的：了解2005～2007年温岭地区血培养分离菌的分布及耐药性。方法：对温岭地区5所二级以上医院2005～2007年12月所有血标本按常规方法进行分离、培养、鉴定。用仪器法进行抗菌药物敏感试验。结果：2005—2007年血培养获分离菌242株，其中革兰阳性球菌占72．3％、革兰阴性杆菌占27．7％；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；葡萄球菌及肠球菌属。葡萄球菌及肠球菌属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：2005—2007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素耐药明显。

Objective：To investigate the distribution and changing pattern of susceptibility of blood culture isolates in Wenling hospitals from 2005 through 2007. Methods： Blood culture of patients in our hospital was performed by BECTEC 9120 and the isolated bacteria were identified by API identified tests（ API Inc, France）. In addition antibiotics sensitivity test by Kirby -Bauer （K - B） as evaluated. Results： A total of 242 strains were isolate＆ Gram positive cocci and Gram negative bacilli accounted for 72. 3% and 27.7% , respectively. The most frequent isolates were coagulase negative Staphylococcus （ CNS, 59.5% ）, Escherichia coli （ 16. 1% ）, Klebsiella spp （ 4. 5 % ）, Staphylococcus aureus （ 7. 9% ） and Enterococcus spp （ 2. 5 % ）. No strains resistant to Vancomycix were found in staphylococci and enterococci. Gram negative bacilli were highly susceptible to carbapenem. Conclusion：Gram positive cocci play an important role in blood stream infections, especially CNS, and Gram positive cocci have been remarkablly increased from 2005 through 2007. Resistances to the first line antibiotics is common among all blood isolates.