275例血培养阳性标本的病原菌构成及耐药性分析

Distribution and resistance analysis of 275 postive isolates from blood culture samples

目的了解医院2009年1月至2010年12月血培养病原菌菌群分布及常见致病菌的耐药情况。方法血液标本在BacT/Alert 3D240全自动培养仪中培养,采用Vitek 2 Compact全自动鉴定药敏分析系统作鉴定及药敏分析。结果 275例血培养阳性患者共分离出细菌276株,其中革兰阴性菌173株,占62.9%,革兰阳性菌89株,占32.4%,真菌14株,占5.09%,感染率最高的细菌是大肠埃希菌88株,占32.0%。血液感染中ICU最高,55株,占20.0%,其次为肿瘤血液科,42株,15.3%;外科感染中最高的为泌尿外科,14株,5.09%;阴性杆菌对亚胺培南、阿米卡星、派拉西林/三唑巴坦较为敏感。葡萄球菌对万古霉素、利福平、莫西沙星和左旋氧氟沙星较敏感。结论及时了解血培养结果可以对临床抗菌治疗提供依据,提高治愈率,对控制医院感染具有重要意义。

Objective To investigate the distribution and resistance of pathogenic bacteria isolated from the blood culture specimens collected form Jan 2009 to Dec 2010. Methods A total of 3,731 blood samples were culture by BacT/ Alert 3D240, using Vitek 2 Compact for identification and drug sensitivity analysis. Results 276 stains were isolated from 275 patients, the isolates included Gram-negative baceria（62.9%）, Gram-positive baceria （32.4）, and fungi （5.09%）. Escherichia coli is the main pathogen （88, 32.0%）. Most of the pathogens were isolated in the ICU （55, 20.0%）, followed by tumors in hematology department （42, 15.3%）; surgical infections was most happen in the urology department（14, 5.09%）; Gram-negative bacilli to imipenem and amikacin, laxilin/tazobactam is more sensitive. Staphylococcus to vancomycin, rifampicin, moxifloxacin and 1-ofloxacin is more sensitive. Conclusion The results of blood cultures can provide a basis for clinical antimicrobial treatment, and it is significant for hospital infection and to improve cure rates.