血流感染的病原菌分布及耐药性分析

Analysis of the pathogenic bacteria distribution and drug resistance of bloodstream infection

目的了解医院血培养病原菌分布及其耐药性,指导临床合理使用抗菌药物。方法血培养采用法国生物梅里埃公司BACT/ALERT3D全自动血培养仪进行培养,阳性标本用西门子MicroScan Walk-Away 40全自动微生物鉴定仪进行鉴定和药敏试验。结果 2 898份血培养标本中分离出病原菌341株,阳性率为11.77%,其中革兰阳性球菌182株,以金黄色葡萄球菌为主;革兰阴性杆菌140株,以大肠埃希菌为主;真菌19株,以白色念珠菌为主。病原菌主要分布于急诊病区、肿瘤内科和重症监护病房。革兰阳性球菌对万古霉素、利奈唑烷和奎奴普丁/达福普丁较敏感;革兰阴性杆菌对亚胺培南、阿米卡星和哌拉西林/三唑巴坦较敏感。结论临床应多做血培养,根据药敏试验结果选用最佳抗菌药物,延缓耐药菌株的产生。

Objective To explore the pathogenic bacteria distribution and drug resistance of pathogens about the blood culture ,in order to guide the rational use of antibiotics .Methods Blood samples were cultured by BACT/ALERT3D of bioMerieux ,and the pathogens identification and drug sensitivity analysis were carried out by Mi-croscan Walk-Away 40 .Results 341 strains were isolated from 2 898 blood samples ,positive rate was 11 .77% . Gram-positive cocci accounted for 182 dominated by Staphylococcus aureus ,and sensitive to vancomycin ,linezolid and quinupristin/dalfopristin ;Gram-negative bacilli accounted for 140 dominated by Escherichia coli ,and highly sensitive to imipenem ,amikacin and piperacillin/tazobactam ;fungi accounted for 19 ,candida albicans was the main pathogen . The pathogens were mainly distributed in the department of emergency physical ,oncology physical and ICU .Conclu-sion More blood culture should be done ,and the best antibacterial drugs should be selected according to the result of drug sensitivity test in order to delay the resistant strains .