1115份血培养病原菌分布及耐药分析

Distribution and drug resistance analysis of pathogen isolated from 1 115 blood culture specimens

目的了解佛山市南海第二人民医院2012年3月至2013年3月血培养病原菌分布及耐药情况,为临床合理用药提供参考。方法血培养采用BacT/Alert 3D全自动血培养仪,鉴定用法国梅里埃ATB Expression鉴定仪进行病原菌鉴定;药敏采用K-B纸片扩散法;数据应用Excel 2003及WHONET5.3软件进行统计学分析。结果 1 115例血培养标本共分离出病原菌81例,阳性率为7.3%。分离病原菌以革兰阴性杆菌为主,54株,占66.7%;革兰阳性球菌为27株,占33.3%;未培养到真菌。检出细菌的前三位为:大肠埃希菌、凝固酶阴性葡萄球菌和肺炎克雷伯菌。美洛培南和亚胺培南对大肠埃希菌和肺炎克雷伯菌100%敏感,万古霉素和呋喃妥因对革兰阳性球菌作用效果很好。结论该院血培养分离的病原菌以革兰阴性杆菌为主,种类复杂,耐药率高,临床医生应合理使用抗菌药物。

Objective To understand the antibiotic resistance and distribution of pathogens isolated from 1 115 blood culture specimens and to provide a basic for clinical diagnosis and treatment. Methods Blood samples were detected by BacT/Alert 3D au- tomated blood culture system. The identification of the bacteria was tested by French bioMerieux ATB Expression. The antimicrobi- al susceptibility tests were performed with Kirby-Bauer disk diffusion method. The results were analyzed by Excel 2003 and WHO- NETS. 3 softwares. Results A total of 81 strains of pathogenic bacteria were isolated from 1 115 blood culture specimens and the positive rate was 7.30/6.54 Gram-negative bacteria strains accounted for 66.7%, 27 Gram-positive bacteria strains accounted for 33.3%, fungi were not isolated. The main pathogenic bacteria were Escherichia coli, coagulase-negative Staphylococcus and Kleb- siella pneumoniae. Meropenem and imipenem strains of Escherichia coli and Klebsiella pneumoniae were 100% sensitive. Vancomy- cin and nitrofurantoin were good for Gram-positive coccus effect. Conclusion Gram-negative bacteria were the main bacteria in blood culture. The species were quite complicate and the drug resistance was high. Clinicians should rationally use antibiotics to pre- vent the overuse of antibiotics and produce new resistant strains.