某院血培养临床分离菌的分布及耐药性分析

Analyse the distribution and drug resistance of the clinical isolates in the blood culture of a hospital

目的分析血培养中分离菌的分布及耐药性,对预防败血症的发生,指导临床合理使用抗菌药物和控制院内感染、抑制耐药菌传播提供重要依据。方法用迪尔DL-Bt64全自动血培养仪进行血培养,阳性菌株用迪尔DL-96 I细菌分析仪进行细菌鉴定及药敏定量试验。结果共送检血培养标本5 314株,分离出病原菌 306株,检出率5. 8%,其中革兰氏阳性菌105株,占分离出病原菌的34. 3%;革兰氏阴性菌182株,占分离出病原菌的59. 5%;真菌19株,占分离出病原菌的6. 2%。排在前10位的分别是大肠埃希菌(21. 6%),凝固酶阴性葡萄球菌(CNS)(18. 6%),肺炎克雷伯菌(13. 4),金黄色葡萄球菌(9. 8%),念珠菌属(8. 5%),鲍曼不动杆菌(5. 6 %),肠球菌属(5. 2%),阴沟肠杆菌(3. 3 %),变形杆菌属(2. 3 %),铜绿假单胞菌(2. 3 %)。大肠埃希菌和肺炎克雷伯菌中产ESBLs株占2种菌的42. 1%,粪肠球菌和屎肠球菌中对高水平庆大霉素耐药的菌株为 61. 1%,耐甲氧西林金黄色葡萄球菌(MRSA)为50.0%,甲氧西林耐药CNS(MRCNS)为45. 6%。结论该院血培养中分离菌以革兰氏阴性杆菌居多,MRSA检出率较高;未发现碳青霉烯类耐药的大肠埃希菌和肺炎克雷伯菌,万古霉素、利奈唑胺和替考拉宁对革兰阳性球菌有很好的抗菌活性,铜绿假单胞菌和鲍曼不动杆菌对多黏菌素B和头孢哌酮/舒巴坦的灵敏度较高。

Objective Analyse the distribution and drug resistance of isolated bacteria in blood culture,and the prevention of septicaemia occurred,and it was important to guide the rational use of antimicrobial agents and control infection in the hospital.Methods With Deere DL-Bt64 automatic blood culture tnstrument for blood culture,positive strains with Deere DL-96 II bacteria analyzer for quantitative bacteria identification and drug susceptibility test.Results Makes a total of 5 314 specimens of blood culture,306 strains pathogenic bacteria isolated,the detection rate of 5.8%,ncluding 105 strains of gram-positive bacteria,accounting for 34.3%of the isolated pathogenic bacteria;182 strains of gram-negative bacteria,accounting for 59.5%of the isolated pathogenic bacteria;fungus 19 strains,accounting for 6.2%of the isolated pathogenic bacteria.Rounding out the top 10,respectively is e.cot(21.6%),coagulase negative staphylococcus(CNS)(18.6%),kleb-siella pneumoniae(13.4),staphylococcus aureus(9.8%),candida(8.5%),acinetobacter(5.6%),enterococcus(5.2%),he sewer e.coli(3.3%),proteus(2.3%),pseudomonas aeruginosa(2.3%).E.cot and klebsiella pneumonia middle ESBLs strains accounted for 42.1%of two kinds of bacteria,and in enterococcus excrement enterococcus of high concentration of gentamicin in drug-resistant strains of 61.1%,methicillin-resistant staphylococcus aureus(MRSA)was 50.0%,methicillin resistant CNS(MRCNS)was 45.6%.Conclusion The isolated bacteria in the blood culture of the hospital were mostly gram-negative bacilli,and the detection rate of MRSA was higher,undetected escherichia coii and klebsiella pneumoniae were not found,vancomycin,linazolamide and the substitute corronin have good antimicrobial activity against gram-positive coccus,pseudo-monas aeruginosa and acinetobacter baumannii have high sensitivity to polymyxin B and cefoperazone/sulbatam.