北京协和医院2008年至2010年血培养菌群分布

Pathogen Distribution of Blood Culture in Peking Union Medical College Hospital from 2008 to 2010

目的了解北京协和医院2008年1月至2010年12月阳性血培养标本的菌群分布。方法采用BacT/Alert 3D 480和BD Bactec 9120型全自动血培养仪进行血液培养,通过Vitek 2 compact、Pheonix 100全自动微生物鉴定仪、API系列试剂盒、Chromagar显色培养基等方法鉴定菌种。结果北京协和医院2008、2009、2010年阳性血培养的菌株数分别为928株、942株、913株,其中分离率最高的细菌是凝固酶阴性葡萄球菌(27.0%、27.7%、26.0%)、其次是大肠埃希菌(13.3%、14.4%、17.1%)、金黄色葡萄球菌(6.8%、6.3%、5.0%)、肺炎克雷伯菌(4.8%、4.1%、6.1%)、鲍曼不动杆菌(4.7%、5.8%、5.6%)、铜绿假单胞菌(3.0%、4.0%、3.4%)、屎肠球菌(5.0%、4.8%、3.0%)、粪肠球菌(2.5%、3.4%、3.0%)。3年间血培养中最常见的真菌为白念珠菌(1.0%、1.6%、2.1%)和近平滑念珠菌(1.1%、0.7%、1.3%)。结论应重视血培养中苛养菌、少见细菌及真菌的分离鉴定。

Objective To investigate the pathogen distribution of positive blood culture in Peking Union Medical College Hospital from January 2008 to December 2010.Methods BacT/Alert 3D 480 and BD Bactec 9120 automatic blood culture instruments were used for blood culture.Microorganism identification methods including Vitek 2 compact and Pheonix 100 microbial identification system,API series kit,and Chromagar chromogenic medium were used to identify the pathogens.Results The number of positive blood culture from outpatients and inpatients of Peking Union Medical College Hospital in 2008,2009,and 2010 was 928,942,and 913,respectively.The most common bacteria was coagulase-negative Staphylococci （27.0%,27.7%,26.0%）,the second was Escherichia coli （13.3%,14.4%,17.1%）,followed by Staphylococcus aureus （6.8%,6.3%,5.0%）,Klebsiella pneumonia （4.8%,4.1%,6.1%）,Acinetobacter baumannii （4.7%,5.8%,5.6%）,Pseudomonas aeruginosa （3.0%,4.0%,3.4%）,Enterococcus faecium （5.0%,4.8%,3.0%）,and Enterococcus faecalis （2.5%,3.4%,3.0%）.The most common fungi from blood culture in the three years were Candida albican （1.0%,1.6%,2.1%） and Candida parapsilosis （1.1%,0.7%,1.3%）.Conclusion We should pay more attention to the isolation and identification of fastidious bacteria,less common bacteria,and fungi.