平谷地区血流感染的病原菌谱及耐药性调查

Pathogenic Bacteria Distribution and Drug Resistance of Blood Stream Infection in PingGu District

目的了解平谷地区血流感染的病原菌种类及耐药性，为临床正确诊断、及时合理应用抗菌药物提供可靠依据。方法采集临床可疑感染患者的标本，用美国BD公司BACTEC9050全自动血培养仪进行培养，以CLSI推荐的纸片扩散法进行药敏试验，对平谷地区2004年1月～2008年12月血培养结果进行回顾性分析。结果2733份血培养标本中阳性309份，阳性率11．1％；以革兰阴性菌为主，占52．1％，革兰阳性菌占45．0％，真菌占2．6％，厌氧菌占0．3％；大肠埃希菌分离率最高，占30．4％，其次为凝固酶阴性葡萄球菌占18．1％，肠球菌属占11．0％，金黄色葡萄球菌占6．8％；大肠埃希菌中产超广谱β-内酰胺酶菌株占52．1％，产AmpC酶菌株占2．1％，耐甲氧西林凝固酶阴性葡萄球菌占92．9％，耐甲氧西林金黄色葡萄球菌占42．9％。耐万古霉素肠球菌占17．6％。结论应加强血流感染的病原菌检测，有针对性地应用敏感抗菌药物治疗。

OBJECTIVE To understand the pathogen distribution and drug resistance of blood stream infection in Ping Gu district and offer reliable basis for reasonable usage of antibiotics. METHODS After the patient＇s specimens were collected culture and antibio, tic sensitivity being done with K B method commended by CLSI. The results of bacterial culture in blood from 2004 to 2008 were analyzed retrospectively. RESULTS A total of 2773 blood samples were cultured and 309 strains pathogenic bacteria were isolated. The positive rate was 11.1%. And the rate of Gram-negative bacteria was 52.1%, Gram-positve bacteria 45.0% fungi 2.6 % ;anaerobe 0.3%. The isolate rate of Escherichia coli was the highest （30. 4%）, followed by CNS （ 18. 1%）, Enterococcus （ 11.0 %）, Staphylococcusaureus （6. 8%）. The rate of E. coli produceing ESBLs was 52. 1%, Ampc 2. 1%; MRCNS 92.9%; MRSA 42. 9; VRE 17. 6%. CONCLUSIONS We should strengthen the detection of pathogens in bloodstream for sensitive antibiotic therapy well targeted.