血液感染的病原菌分布及耐药性分析

目的分析海南省人民医院菌血症、败血症患者感染病原菌分布及耐药情况。方法血液标本采用标准需氧瓶或厌氧瓶增菌培养，用Back／Alert120血培养仪进行检测后，用VITECK-32全自动微生物分析仪器及鉴定卡分析。结果195例血液标本共分离出病原菌179例，总阳性率为91．79％，革兰氏阳性菌检出率为41％，革兰氏阴性菌检出率为31％，真菌检出率为28％。位于前5位的细菌为：白假丝酵母菌、表皮葡萄球菌、金黄色葡萄球菌、大肠埃希菌和棒状杆菌。药敏结果显示。肠杆菌科、葡萄菌属对常用抗菌素的耐药率均在50％以上。金黄色葡萄球菌、大肠埃希菌和铜绿假单胞菌的染色体携带有自己独特的质粒，携带率分别为63．5％、66．7％和50％。结论血液感染分离的病原菌对多种抗菌素耐药，耐药机制和质粒有关，提示临床医生应根据药敏实验结果选择抗菌素。

Analyses on the distribution of blood infection and drug resistance of pathogen

Objective To analyze the distributpathogens isolated from blood samples with bacteremia or septicemia in Haian People Hospital .Methods Blood sample select standard aerobic bottle for use or detest oxygen bottle increase fungus train, train appearance go on after measuring with VITEK-32 instrument and determine with Back/Alert120 full-automatic blood card analyses determine. Results 195 copies of blood culture samples to isolate and cause 179 trains altogether, total positive rate is 91.79%. Gramaegative bacteria is 31% and Gram-posltive bacteria is 41%. Fungus is 28% .The first five isolated bacteria were candies albieans, S. cpidcmidis, Eschcrlchia coli, staphyloccus aurous and corynebacterium. Medicine quick result shows Eseherlchia,Staphyloeoceus belong to drug resistance rate above 50% common antibiotic. Each strain has its own specific plasmid pattern. Staphyloceceus auneus, Escherichia coli and Pseudomonas aeruginose carrying plasnfid is 63.5 %, 66.7 % and 50% respectively. Conclusion Blood infeetion has high drug resistance to comrnouly use many kinds of antibiotic; drug resistance related on the plasmld, pointing out clinicians should select the antibiotic for use rationally according to the quick result of the test of medicine.