无锡地区2012年血培养病原菌分布和耐药性分析

Distribution and antimicrobial resistance analysis of blood culture isolates in 2012

目的了解南京医科大学附属无锡人民医院2012年血培养阳性标本的病原菌分布及耐药现状。方法采用BacT/Alert 3D全自动血培养仪,VITEK 2-Compact全自动微生物分析仪进行鉴定和药敏试验,并用WHONET 5.4软件对药敏结果进行统计分析。结果 2012年南京医科大学附属无锡人民医院血培养共分离出病原菌626株,阳性率为13.8%。其中革兰阳性菌247株,占39.5%;革兰阴性菌364株,占58.1%;真菌15株,占2.4%。血培养阳性菌多见于血液科、ICU及脑外科。检出率较高的革兰阳性菌主要为凝固酶阴性葡萄球菌(CNS)和金黄色葡萄球菌,耐甲氧西林葡萄球菌分离率较高(占47.4%)。未发现对万古霉素、利奈唑胺、替加环素和喹奴普汀/达福普汀的耐药株。肠杆菌科细菌对碳青霉烯类抗菌药物敏感率较高,铜绿假单胞菌和鲍曼不动杆菌对多种抗菌药物耐药率较高。结论 2012年该院血流感染以革兰阴性菌为主,耐药率较高,临床治疗应根据药敏试验结果合理选用抗菌药物。

Objective To investigate the Distribution and antimicrobial resistance analysis of positive isolates of blood culture from Wuxi People′s Hospital Affiliated to Nanjing Medical University in 2012.Methods All blood samples were cultured by BacT/Alert 3D,and the identification and susceptibility of bacteria were tested by VITEK 2-Compact.WHONET 5.4 was used for statistical analysis.Results The total number of positive strains of blood culture in 2012 was 626,and the positive rate was 13.8%,including 247 gram-positive bacteria strains （39.5%）,364 gram-negative bacteria strains （58.1%）and 15 candida strains （2.4%）.The blood culture isolates were mostly isolated from the department of hematology,ICU and neurosurgery.The gram-positive bacteria with high detection rate included coagulase-negative staphylococcus（CNS）and Staphylococcus aureus.Among them,the prevalence of methicillin resistant staphylococcus（MRS）strains was 47.4%.No strains was found resistant to vancomycin,linezolid,tigecycline and quinupristin/dalfopristin.Enterobacteriaceae were highly susceptible to carbapenem.High resistant rates were seen in Pseudomonas aeruginosa and Acinetobacter.Conclusion There are many kinds of pathogens in positive blood culture,and they are resistant to a variety of antimicrobial agents.Antibiotics should be chosen according to resistance analysis.