血流感染中厌氧菌的分布及耐药性分析

Analysis of distribution and drug resistance of Anaerobic bacteria in bloodstream infection

目的了解血流感染中厌氧菌的分布及耐药性,给临床合理用药提供依据。方法采用全自动BACTEC 9120血培养仪培养血液,梅里埃VITEK 2 Compat鉴定系统及ATB NAN药敏试剂盒鉴定菌株及药敏。结果47152份血培养中共检出兼性厌氧菌3327株,专性厌氧菌236株,236株专性厌氧菌主要来自产科、消化内科、新生儿监护病区,其中分离率居前3位的分别为脆弱拟杆菌(42株)、厌氧消化链球菌(37株)、产气荚膜梭菌(26株),分别占17.8%、15.6%、11.0%,不同菌株对抗菌药物的耐药率有较大差异,对青霉素耐药率较高,对甲硝唑的敏感性较高。结论厌氧菌的分布及耐药性不尽相同,临床应根据药敏结果合理选用抗菌药物,避免更多耐药菌株的出现。

Objective To investigate the distribution and drug resistance of Anaerobic bacteria in bloodstream infections,and to provide basis for clinical rational drug use. Methods Automatic BACTEC 9120 was used to culture the blood,and the strain and drug sensitivity were identified by the Merieux VITEK 2 Compat identification system and the ATB NAN drug sensitivity kit.Results A total of 3 327 facultative Anaerobic bacteria and 236 obligate Anaerobic bacteria were detected in 47 152 blood cultures. 236 obligate Anaerobic bacteria were mainly from obstetrics,gastroenterology and neonatal intensive care units. The top three were Bacteroides fragilis( 42 strains),Anaerobic digestive streptococci( 37 strains),and Clostridium perfringens( 26 strains),accounting for 17. 8%,15. 6%,and 11. 0%,respectively. The drug resistance rate is quite different,the resistance rate to penicillin is higher,and the sensitivity to metronidazole is higher. Conclusion The distribution and drug resistance of Anaerobic bacteria are not the same. Doctors should choose drug according to the results of drug susceptibility to avoid the emergence of more resistant strains.