血培养阳性标本352份的细菌分布及耐药性分析

Bacterial distribution and antibiotic resistance analysis of 352 positive blood-culture samples

目的了解血培养阳性标本细菌分布及耐药情况,为菌血症、败血症的诊断及临床用药提供依据。方法回顾分析2011年江阴市人民医院住院及门诊病人送检的血培养阳性标本。采用美国BD公司的BACTEC9120全自动血培养仪及法国梅里埃公司的VITEK32全自动细菌分析仪对阳性标本进行鉴定及药敏试验。结果 352份血培养阳性标本中革兰阳性菌173株,占49.15%;以表皮葡萄球菌、溶血性葡萄球菌、金黄色葡萄球菌为主,对大多数试验药物敏感性较高,但对青霉素均耐药。革兰阴性菌176株,占50.00%;以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,除铜绿假单胞菌耐药性较高外,其他2种菌对多数抗菌药敏感程度较高。另外,还检出1株白假丝酵母菌,1株热带假丝酵母菌,1株厌氧菌。结论血培养分离的病原菌中革兰阳性菌与革兰阴性菌所占比率差别不大,但病原菌种类较多,根据耐药试验结果,提示应高度重视合理使用抗菌药物,减少细菌耐药性产生,以提高临床治疗效果。

[ Objective] To understand the bacterial distribution and antibiotic resistance of blood-culture samples, and provide evidence for diagnosis and clinical treatment of bacteremia and sepsis. [ Methods] Retrospective analysis was performed on positive blood-culture samples collected from inpatients and outpatients of Jiangyin People＇s Hospital in 2011. The identification and susceptibility testing were performed by BD BACTEC9120 automated blood culture system and Merieux VITEK32 fully automated bacterial analyzer. [Results] Of 352 samples, 173 （49. 15% } were Gram-positive, the major were staphylococcus, Hemolytic staphylococcus and Staphylococcus aureus which were sensitive to most antibiotics, but resistant to penicillin; 176 （50. 00 ） were Gram-negative, most were Escherichia coli , KlebsieUa pneumoniae and Pseudomonas aeruginosa, except Pseud0monas aeruginosa, the others were sensitive to most antibiotics. In addition, 1 strain of Candida albicans, 1 strain of Candida tropwalls ＇ yeast and 1 strain of anaerobic bacteria were detected. [ Conclusion] Gram-positive and Gram-negative bacteria are isolated from blood-culture samples with a similar number and many types. The resistance test results shows that rational use of antibiotics should attach importance to reduce bacterial resistance and to improve clinical efficacy .