血培养标本病原菌的科室分布及耐药性分析

Analysis on Distribution in Different Departments and Drug Resistance of Pathogens from Blood Culture Samples

目的了解医院血培养阳性病原菌的科室分布及对抗菌药物敏感性,为临床治疗提供依据。方法采用WHONET 5.6软件对2010年6月-2011年7月血培养结果进行回顾性分析。结果 1895件血培养标本共分离出病原菌398株,阳性率为21.0%,其中革兰阳性球菌占79.9%,革兰阴性杆菌占16.8%,真菌占3.3%。表皮葡萄球菌主要分布在围产儿科和重症医学科,溶血葡萄球菌主要分布在围产儿科,人葡萄球菌主要分布在呼吸内科、泌尿科和血液肿瘤科,大肠埃希菌主要分布在泌尿科、血液肿瘤科和内分泌肾科,铜绿假单胞菌主要分布在重症医学科。凝固酶阴性葡萄球菌的耐药率高于金黄色葡萄球菌,未发现耐万古霉素、利奈唑胺、奎奴普丁的葡萄球菌;未分离出耐亚胺培南的大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌。结论血培养阳性病原菌在不同科室的分布和抗菌药物敏感性不同,医生应了解本科室细菌分布及药敏情况,合理使用抗菌药物。

Objective To investigate the distribution in different departments and antimicrobial susceptibility of positive patho- gens of blood culture samples, and provide evidence for the clinical treatment. Methods The blood culture results （June 2010- July 2011 ） were analyzed retrospectively by WHONET 5.6 software. Results All 398 pathogens were isolated from 1895 blood culture samples, the positive rate was 21.0%, including gram-positive cocci （79.9%）, Gram-negative bacilli （16.8%） and fungi （3.3%）. Staphylococcus epidermidis was mainly distributed in the perinatal pediatric department and ICU;Staphylococcus haemolyticus was mainly in the perinatal pediatric;Staphylococcus hominis was mainly in respiratory medicine department, urology department, hematology and oncology department;Escherichia coli was mainly in urology, hematology and oncology department, renal and endocrine department;Pseudomonas aeruginosa was mainly in ICU. The drug resistance rate of Coagulase-negative staphy- lococci was obviously higher than that of Staphylococcus aureus. Such Staphylococcus was not found that showed the resistance to Vancomycin, linezolid and quinupristin. No Escherichia coli, pneumonia Klebsiella and Pseudomonas aeruginosa isolated was resistant to Imipenem. Conclusion The distribution in different departments and antimicrobial susceptibility of positive pathogens of blood culture samples was different. Physicians should know the difference of distribution and Antimicrobial susceptibility of pathogens and then rationally use the antibiotics.