6445份血培养分离菌的分布特征及耐药谱型研究

Distribution and Antibiotic Resistance of Isolates from 6 445 Blood Cultures

目的 统计分析我院 1996～ 2 0 0 2年 7年血培养分离菌的分布特点及耐药情况。方法 采用全自动血培养仪Bact/Alert 12 0及专用血培养瓶 ,阳性血培养转种血平板和巧克力平板 ,进行常规细菌鉴定 ,药敏试验采用K B法。结果 2 0 0 0～ 2 0 0 2年血培养阳性率较高 ,分别为 11.5 5 %、11.84 %和 11.5 6 % ,1996年血培养阳性率最低 ,仅为 5 .0 9% ;革兰阳性球菌以金黄色葡萄球菌和表皮葡萄球菌占优势 ,革兰阴性杆菌以大肠埃希菌和铜绿假单胞菌居多 ,真菌以白色念珠菌居多 ;金黄色葡萄球菌和表皮葡萄球菌对万古霉素、头孢哌酮 /舒巴坦和亚胺培南/西司他丁敏感 ,头孢哌酮 /舒巴坦和亚胺培南 /西司他丁对大肠埃希菌和铜绿假单胞菌较敏感。结论 菌血症、败血症和真菌血症临床死亡率较高 ,临床医师应加强血液感染患者血液中病原菌的检测 ,以利于疾病的治疗。

OBJECTIVE To analyse the distribution features and antibiotic sensitivity of isolates from blood cultures in our hospital from 1996 to 2002. METHODS A total of 6445 blood cultures were determinated by Bact/Alert 120, Bact/Alert FAN and PF bottles. The positive blood cultures were reinoculated on sheep blood agar and chocolate plate.All of the isolates were tested by K-B susceptibility. RESULTS The rate of isolation was higher during 2000-2002 (11 55%,11.84% and 11.56%, respectively), than that in 1986. Among Gram-positive cocci, Staphylococcus aureus and S.epidermidis were the most frequent isolated, and among Gram-negative bacilli, Escherichia coli and Pseudomonas aeruginosawere common. S.aureus and S.epidermidis were more sensitive to vancomycin, cefoperazone/sulbactam and imipenem, P.aeruginosa and E.coli were more sensitive to cefoperazone/sulbactam and imipenem. CONCLUSIONS The mortality due to bacteremia and candidemia are more higher. Doctors should pay attention to the detection of pathogens in blood which is helpful to clinical therapy.