发热患者血培养阳性的病原菌分布和耐药性研究

Analysis of the distribution and drug resistance of bacteria in blood culture in fever patients

目的回顾性分析本院3年来血培养阳性中分离的病原菌的阳性率、分布及耐药情况,为临床合理使用抗生素提供科学根据。方法采用法国梅里埃公司的双相培养瓶和API细菌鉴定分析系统进行血培养和微生物鉴定,用ATB自动细菌鉴定及药敏分析仪和K-B法进行药敏试验。结果 596例血培养中共检出阳性菌株61株(10.23%),其中革兰阳性菌27株(44.3%)、革兰阴性菌34株(55.7%),感染率最高的是大肠埃希菌、凝固酶阴性葡萄球菌、金黄色葡萄球菌、肺炎克雷伯菌。大肠埃希菌和肺炎克雷伯菌对阿莫西林、替卡西林高度耐药,分别为87.5%和100%;葡萄球菌对青霉素耐药率为85.71%。结论大肠埃希菌可能是本院院内感染的主要细菌,检出的细菌抗生素耐药率高,临床应加强对发热疑为败(菌)血症患者的进行血标本培养检测,以便尽早、准确、合理的应用抗生素,从而减少细菌耐药性产生,提高临床治疗效果。

Objective To investigate the positive rate,distribution and drug resistance of pathogenic bacteria in blood culture in the Second People′s Hospital of Liwan District in the recent years.Methods We used mutually development bottle and API germ authenticate analysis system to do the blood culture,and drug sensitivity was tested by using ATB analysis and K-B method.Results Among 596 blood culture,61 strains（10.23%）of bacteria were isolated,27 strains of gram-positive（44.3%）,34 strains of gram-negative（55.7%）.The result showed that Escherichia coli,coagulase negative staphylococcus,stayphylococcus aureus,klebsiella pneumoniae had high infection rates.The resistance rates of Escherichia coli and kledsiella pneumoniae to ampoxicillin,ticarcillin were high（87.5%,100%）,and the resistance rate of staphylococcus was 85.71%.Conclusion Escherich coli is the main pathogens in the blood culture in our hospital,It suggests that antibiontics should be used rationally and we should reduce drug resistance of bacteria to improve curative effect.