256例血培养阳性病原菌分布及耐药性分析

Pathogens Distribution and Antibiotic Resistance in 256 Cases of Positive Blood Culture

目的:分析本院2012年3月-2015年8月血培养阳性病原菌的种类和耐药情况,指导临床合理使用抗生素。方法:采用Bac T/Alert 3D 120全自动血培养仪进行血液标本培养和法国梅里埃ATB Expression细菌鉴定仪进行鉴定及药敏试验,数据分析采用Whonet 5.6软件。结果:共分离出病原菌256例,其中革兰阴性杆菌140例,占54.7%;革兰阳性球菌95例,占37.1%;真菌15例,占5.9%;其他6例,占2.3%。居前三位的感染病原菌依次为大肠埃希菌42例、凝固酶阴性葡萄球菌(CNS)29例、肺炎克雷伯菌25例。大肠埃希菌对美罗培南和亚胺培南敏感率为100%,对其他革兰阴性菌药物均有耐药;葡萄球菌对万古霉素敏感率100%,但肠球菌对万古霉素有耐药。结论:医院血培养分离的病原菌种类广泛,耐药性差异较大,对血培养分离株进行早期监测和耐药性分析非常必要,可为临床医师合理应用抗菌药物提供重要依据。

Objective： To analyze the pathogens distribution and their antibiotic resistance in 256 cases of positive blood culture in our hospital from March 2012 to August 2015 so as to guide the rational use of antibiotics. Method： The BacT/Alert 3D 220 blood culture systems were used to perform the blood culture.The identification of isolated bacteria and the drug susceptibility test were conducted by using ATB Expression.The data were analyzed by adopting the Whonet 5.6 software.Result： There were 256 strains bacteria were dectected, 140 strains were Gram negative bacilli, accounting for 54.7%; 95 strains were Gram positive coccus, accounting for 37.2%; 15 strains were fungus, accounting for 5.9%; 6 strains were other bacteria, accounting for 2.3%.The top three pathogens of infection were The most commom pathogens were E.coli （ 42 strains ）, CNS （ 29 strains ）, Klebsiella pneumonia （ 25 strains ） .The susceptible rates of E.coli and Klebsiella pneumonia were 100% to Meropenem and Imipenem, but they had resistance to other antibiotics; the susceptible rates of Staphylococcus to Vancomycin was 100%, but Enterococcus Faecium was resistant to Vancomyein.Conclusion： The pathogens spectrum detected by blood culture is widespread and the antibiotic resistance rates of different bacteria vary widely.h is very necessary to detect the pathogens spectrum in early time and analyze the antibiotic resistance, which can guide the rational use of antibiotics so as to reduce the abuse of antibiotic and the generation of antibiotic resistance of bacteria.