重症急性胰腺炎患者血液病原菌感染特征分析

The analysis of Pathogen Species Distribution and Drug Resistance in Blood Culture of Serious Acute Pancreatitis Patients

目的对重症急性胰腺炎患者血流感染的病原菌种类分布及其耐药情况进行分析,为更好了解重症急性胰腺炎血流感染的特征,为病原菌检验和临床用药提供指导。方法利用BecT/Alert3D全自动血培养仪来培养和监测重症急性胰腺炎患者血液标本,待血液培养瓶报阳性后及时转种平板培养基分离出病原菌,然后Vitek 2Compact全自动微生物分析系统鉴定病原菌,并分析药敏实验。结果从132例重症急性胰腺炎患者的血培养标本中分离出病原菌39例,鲍曼不动杆菌、大肠埃希菌和凝固酶阴性葡萄球菌比较多见。其中鲍曼不动杆菌对碳氢酶烯类的耐药率为66.7%,产ESBLs的大肠埃希菌检出率为57.1%,耐甲氧西林的凝固酶阴性葡萄球菌检出率为85.7%。结论重症急性胰腺炎患者血流感染以鲍曼不动杆菌和大肠埃希菌为主,有较大的耐药性,且呈多重耐药。

Objective To analyze the species distribution and resistant characteristics of pathogenic bacteria isolated from blood cultures of patients with severe acute pancreatitis,and to better understand the characteristics of the bloodstream infected complications of severe acute pancreatitis,and to provide guidance for examination of bacteria and clinical cure by medication.Methods Blood samples of patients with severe acute pancreatitis were cultivated and continuously monitored by BacT/Alert 3 Dautomated blood culture system and bacteria in the positive bottles were purred by being transferred timely to plate culture.The identifications of bacteria and drug tests were performed by Vitek 2 compact bacterial automatic analyzer.Results There were 39 kinds of bacteria in 132 blood samples of patients with severe acute pancreatitis.The firstly three species were Acinetobacter baumannii,Escherichia coli and CNS.The resistant rates of Acinetobacter baumannii to imipenem were 66.7%,and 57.1% of Escherichia coli were ESBLs producers,methicillin resistant strains in CNS were accounted for 85.7%.Conclusion Acinetobacter baumannii and Escherichia coli were predominant in pathogenic bacteria of blood infected samples of patients with severe acute pancreatitis,which greatly differently showed a multi-drug resistance.