2007-2011年血流感染病原菌分布及耐药率变迁情况分析

Analysis of the distribution and drug resistance of pathogens in bloodstream infection from 2007 to 2011

目的探讨我院2007-2011年血流感染病原菌分布及耐药率情况,为临床经验用药提供依据。方法采用全自动血培养仪进行血液培养,阳性标本分离培养后用全自动微生物分析系统VITEK 2 Compact进行菌种鉴定,药物敏感性试验采用手工琼脂扩散敏感试验(kirbry-bauer,K-B)和仪器卡片法,对结果进行数据统计分析。结果 5年间我院血流感染的病原菌以革兰阴性杆菌为主占52.6%,革兰阳性菌和真菌分布占42.8%和4.6%;除金黄色葡萄球菌和肺炎克雷伯菌外,其他病原菌分离率无明显上升趋势,耐药分析显示耐药率整体稳定;病原菌对大部分临床常用抗生素具有较高的耐药率,未出现明显上升趋势。结论及时关注血流感染病原菌分布情况及耐药动态,对于控制耐药菌的传播、指导临床经验用药具有非常重要的意义。

Objective To investigate the distributions and drug resistance rates of pathogens isolated from blood infectious patients in our hospital from 2007 to 2011. Methods Bact/Alert 3D automatic blood culture system was applied for blood cultures and VITEK 2 Compact was used to identify the positive samples. The antimicrobial susceptibility tests were performed with Kirbry-Bauer （K-B） and VITEK 2 Compact antibiotic suseptibility test methods respectively. Results The Gram-negative bacteria, with the isolate rate 52.6% , were predominant among the blood infectious pathogens in the last five years. The proportions of Gram-positive bacteria and fungi were 42. 8% and 4.6%, respectively. The ratios were not obviously increased among the five years except for Staphylococcus aureus and Klebsiella pneumoniae. The data showed a relatively stable drug resis- tance rates on the whole. The pathogens presented higher resistance rates to majority antibiotic and no notable rising was happened. Conclusion The predominant bacteria were identical generally among different years and the isolation rates appeared no obviously increasing trend.