632例血培养阳性标本的病原菌分布及耐药性分析

Distribution and drug resistance of pathogens in 632 samples of positive blood culture

目的分析我院近2年血培养阳性标本中病原菌的分布及耐药状况,为临床合理用药提供参考。方法对我院2012年1月至2013年12月送检的血培养标本检出菌的分布和药物敏感性试验结果进行回顾性分析。结果 632株病原菌中,革兰阴性菌381株(60.28%),前2位是肺炎克雷伯菌105株(16.61%)、大肠埃希菌101株(15.98%);革兰阳性菌209株(33.07%),前2位是凝固酶阴性葡萄球菌(CNS)117株(18.51%)、肠球菌40株(6.32%);真菌42株(6.65%);主要革兰阳性菌对万古霉素、利奈唑胺、呋喃妥因、利福平敏感,对青霉素、红霉素耐药性严重。主要革兰阴性菌对亚胺培南、头孢哌酮/舒巴坦敏感。结论 CNS为我院血液感染的主要病原菌,其耐药情况严重。分析和监测血培养病原菌分布及其耐药性,对合理使用抗菌药物具有重要指导意义。

Objective To analyze the distribution and drug resistance of pathogens in the samples of positive blood culture in our hospital in last 2 years, so as to provide evidence for rational application of drugs clinically. Methods The distribution of detected pathogens in blood culture performed by our hospital from January, 2012 to December, 2013 and the test results of drug-sensitive tests were analyzed retrospectively. Results Of the 632 strains of pathogens, 381 strains were Gram negative bacilli, accounting for 60. 28%. The first 2 pathogens were Klebsiella pneumoniae（ 105 strains, accounting for 16.61% ）and Escherichia coli（ 101 strains, accounting for 15.98% ）. Two hundred and nine strains were Gram positive cocci, accounting for 33.07%. The first 2 pathogens were coagulase negative Staphylococcus （ CNS ） （ 117 strains, accounting for 18. 51% ） and Enterococcus （ 40 strains, accounting for 6. 32% ）. There were 42 strains of fungi, accounting for 6.65%. Gram positive cocci displayed serious drug resistance to vancomycin, linezolid, furantoin, rifampicin, as well as penicillin and erythromycin. Main Gram negative bacilli were sensitive to imipenem and eef- operazone sulbactam. Conclusion Coagulase negative Staphylococcus （CNS） was the main pathogen from blood culture in our hospi- tal, with serious drug resistance. Analysis and monitoring in the distribution and drug resistance of pathogens from blood culture were of guiding significance to rational application of antibaeterials.