4年血液培养病原菌分布及耐药性变迁

目的]了解某院4年血培养标本病原菌构成及其对抗菌药物的耐药性,为临床合理用药提供依据。方法]收集门诊及住院患者血培养阳性鉴定及药敏试验结果,并对病原菌分布和耐药性作统计分析。结果]4年分离血培养阳性菌共633株,阳性率为633/6135(10.31%),其中革兰阴性菌240株,年均检出率为37.91%,革兰阳性菌354株,年均检出率为55.92%,念珠菌39株,年均检出率为6.16%。金黄色葡萄球菌、大肠埃希菌、表皮葡萄球菌为检出病原菌前3位,年均检出率分别为18.17%、15.64%、17.22%,革兰阴性菌对AMP、TZP、CFP、ATM等抗生素2006年与2009年比较差异均有统计学意义(P﹤0.05),革兰阳性菌对P、CTX、LEV、DA、AZM等抗生素耐药率呈不断上升趋势,且2006年与2009年比较差异均有统计学意义(P﹤0.05),亚胺培南、万古霉素对革兰阴性菌和革兰阳性菌敏感性最高分别为1.92%、0.68%。结论]血液培养病原菌中,金黄色葡萄球菌、大肠埃希菌分别为革兰阳性和阴性病原菌首位,耐药菌株逐年增加,应及时检测病原菌及耐药情况。

DISTRIBUTION AND DRUG RESISTANCE OF PATHOGENIC BACTERIA IN BLOOD CULTURES IN 4 YEARS

Objective]To investigate the distribution and drug resistance of pathogenic bacteria in blood culture so as to provide a basis for rational use of antibiotics in clinic.Methods]Blood specimens,collected from outpatients and inpatients during 2006-2009 in our hospital,were cultured and drug sensitivity tests were conducted.The distribution and drug resistance of pathogenic bacteria in blood culture were studied and analyzed.Results]Among all the blood samples in the past four years,633 strains of pathogenic bacteria were isolated.The positive isolating rate was 10.31%(633/6 135).240 strains of gram-negative bacteria were isolated,the annual detection rate was 37.91%.354 strains of gram-positive bacteria were isolated,the annual detection rate was 55.92%.39 strains of monilia,annual detection rate was 6.16%.Staphylococcus aureus,Escherichia coli and Staphylococcus epidermidis were three dominant strains,the annual detection rate was 18.17%,15.64%,17.22% respectively.The drug resistances of gram-negative bacteria to AMP,TZP,CFP,ATM were different in 2006 and 2009(P﹤0.05),the drug resistances of gram-positive bacteria to P,CTX,LEV,DA,AZM were increased and different in 2006 and 2009(P﹤0.05).The sensitivities of gram-negative bacteria and gram-positive bacteria to imipenem and vancocin were 1.92% and 0.68% respectively.Conclusion]Staphylococcus aureus and Escherichia coli are the most common pathogens in gram-positive bacteria and gram-negative bacteria,respectively.Drug resistance of isolated pathogenic bacteria in blood cultures is prevalent and serious.Monitoring the changes of pathogens and trends of drug resistance is vital.