摘要
目的了解血培养病原菌分布特点及耐药性,为临床合理选用抗菌药物提供依据。方法使用Bac T/Alert 3D全自动血培养仪对6 067份临床采集的血液进行培养,血培养阳性株采用VITEK 2 Compact全自动微生物分析系统进行鉴定,用纸片扩散法进行体外药敏试验。结果送检血培养样本6 067份,血培养阳性菌株为232份(3.82%),其中革兰阳性菌(G+)155株(66.81%),革兰阴性菌(G-)67株(28.88%),真菌10株(4.31%)。从检出的情况看,排在前3位的G+菌为人葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌;G-菌为大肠埃希菌、肺炎克雷伯杆菌、鲍曼复合醋酸不动杆菌。革兰阳性球菌对万古霉素、利奈唑胺、替加环素、喹奴普汀/达福普汀敏感性较高,耐甲氧西林人葡萄球菌、表皮葡萄球菌、金黄色葡萄球菌的检出率分别为58.82%、81.82%、50.00%。革兰阴性菌中大肠埃希氏菌和肺炎克雷伯杆菌产超广谱β-内酰胺酶(ESBLs)的检出率均为100.00%,厄他培南和亚胺培南依然保持高度抗菌活性,敏感率达100.00%,但鲍曼复合醋酸不动杆菌存在严重的多药耐药现象。结论我院血培养的阳性率及细菌耐药率均较高,且耐药性有上升趋势,临床应合理选择抗菌药物,采用联合用药、交替用药方式,警惕多重耐药菌株。
Objective To investigate the distribution and antibiotic resistance of pathogens in blood cultures,and provide a basis for rational use of antibiotics. Methods 6,067 blood samples were collected for bacterial culture using Bac T / Alert3 D automatic blood culture instrument; the positive strains were identified using VITEK 2 Compact automatic microorganism analysis system,and the antibiotic sensitivity was tested with disc diffusion method in vitro. Results A total of 232 strains were isolated,including 155 strains of Gram-positive bacteria( 66. 81%),67 strains of Gram-negative bacteria( 28. 88%) and 10 strains of fungi( 4. 31%). Staphylococcus hominis,Staphylococcus epidermidis and Staphylococcus aureus were the top three Gram-positive bacteria,while Escherichia coli,Klebsiella pneumonia and Acinetobacter baumannii were the most predominant Gram-negative bacteria. The Grampositive bacteria were still sensitive to Vancomycin,Linezolid,Tigecycline and Quinupristin-Dalfoprisdn. The detection rate of methicillin-resistant S. hominis,S. epidermidis and S. aureus was 58. 82%,81. 82% and 50. 00%respectively. Among the Gram-negative bacteria,E. coli and K. pneumoniae were all extended-spectrum β-lactamases( ESBLs) producing strains,but were still highly susceptible to Ertapenem and Imipenem,whereas A. baumannii showed serious multi-drug resistance. Conclusion The positive rates of blood culture and the rates of antibiotic resistance are still high in our hospital,with an increasing trend of drug resistance,which suggests that reasonable choice of antibiotics in clinical practice and monitoring on multi-drug resistant bacteria are very important.
出处
《中国微生态学杂志》
CAS
CSCD
2015年第9期1052-1054,1061,共4页
Chinese Journal of Microecology
关键词
病原菌
感染
血培养
耐药性
Pathogens
Infection
Blood cultures
Antimicrobial resistance