6505份血培养病原菌分布及耐药分析

Distribution and Drug Resistance Analysis of Pathogen Isolated from 6 505 Blood Culture Specimens

目的了解长征医院2009年8月-2011年8月血培养病原菌构成比、分布及耐药特点，为临床抗感染治疗提供依据。方法血培养采用VersaTrek和BACKET9120全自动血培养仪，鉴定用VITEK2-compact细菌鉴定仪进行病原菌的培养分离与鉴定；药敏采用K—B法；WHONET5．3软件进行统计分析。结果6505份血培养标本中，469份血培养阳性，分离菌以革兰阴性杆菌为主，共256株，占54．58％；革兰阳性球菌104株，占22．17％；真菌37株，占7．89％。检出细菌前三位：大肠埃希菌、肺炎克雷伯菌和鲍曼不动杆菌。亚胺培南与美洛培南对大肠埃希菌和肺炎克雷伯菌作用效果较好，万古霉素、利奈唑胺对阳性菌100％敏感，其余抗菌药物均有不同程度的耐药。结论血培养分离的病原菌以革兰阴性菌为主，种类复杂，耐药率高，提示临床医生应合理应用抗菌药物，防止抗生素滥用及新耐药株的产生。

Objective To understand the antibiotic resistance and distribution of pathogens bacteria isolated from 6 505 blood culture specimens and to provide a basic for clinical diagnosis and treatment. Methods Blood samples were detected by VERSA TREK and BACKET9120 automated blood culture system, and antimicrobial susceptibility tests were performed with Kirby-Bauer disk diffusion method,results were analysed by WHONETS. 3 software. Results Among 6 505 samples, 469 were blood culture positive,256 gram-negative bacteria strains accounted for 54.58~ ,mainly Escherichia coil, Klebsiella, Pneumoniae and Acinetobacter baumannii; 104 gram-postive bacteria strains accounted for 22.17 ~,37 fungi strains accounted for 7.89~. Imipenem, meropenem against Escherichia coli, KlebsieLLa pneumoniae effect of good, Vancomycin, teicoplanin,and nitrofurantoin remained highly sensitive to the gram positive bacteria. Conclusion Gram-negative bacteria were the main bacteria in blood culture, the species from which was quite complicated,and the drug resistance was high. Strengthen blood culture pathogens and drug resistance monitoring, for the rational use of antimicrobial drugs,prevent the emergence of new drug-resistant strains.