3031份血培养中病原菌分布及药物敏感性分析

Distribution and Drug Sensitivity Analysis of Pathogens Isolated From 3 031 Blood Culture Specimens

目的:了解2009～2011年我院血培养标本中病原菌的分布及耐药情况。方法:采用BacT/Alert 3D全自动血培养仪,法国生物梅里埃VITEK-2全自动细菌分析仪进行菌种鉴定和药敏试验,用WHONET5.4软件进行数据分析。结果:3 031份血培养标本中分离出356株病原菌,阳性率为11.7%,其中革兰阳性球菌174株,占48.9%;革兰阴性杆菌145株,占40.7%;真菌37株,占10.4%。葡萄球菌属中耐甲氧西林葡萄球菌已占绝大多数,对万古霉素、利奈唑胺、替考拉宁、喹奴普汀/达福普汀保持高度敏感;革兰阴性菌(除铜绿假单胞菌)对亚胺培南高度敏感,对其他抗菌药物敏感率较低,且表现多药耐药性。结论:临床应加强血培养检测,并根据早期诊断及最后药敏结果合理调整抗菌药物的使用。

Objective： To investigate the distribution and drug resistance of pathogenic bacteria isolated from blood culture specimens collected from 2009 to 2011. Methods BacT/Alert 3D automated blood culture instrument was adopted, bacteria identification and susceptibility testing were performed with VITEK-2 full-automatic bacteria analyzer of M e rieux （France）; statistical analysis was performed by using software WHONET 5.4 Results： Totally 356 strains of pathogens were isolated from 3 031 blood cultures samples with the positive rate of 11.7%, including 174 strains （48.9%） of gram-positive cocci, 145 strains （40.7%） of gram-negative bacilli, 37 strains （10.4%） of fungi. Most Staphylococcu were methicillin resistance Staphylococcus which highly susceptible to vancomycin nezolid, haemolyticus and quinupristin/dalfopristin. The susceptibility of gram-negative bacteria （except Pseudomonas aeruginosa） to antibiotics were low except for imipenem Multi-drug resistance was observed. Conclusions： Clinical detection of blood culture should be strengthened and based on early diagnosis and the final drug susceptibility results rationalize the use of antibiotics