血培养阳性标本细菌分布及耐药性分析

目的:了解血培养阳性标本中分离的病原菌分布及耐药情况，为临床合理使用抗生素提供治疗依据。方法:回顾分析2014年7月至2015年6月临床送检血培养标本中分离的病原菌及药敏试验结果，采用BACT/ALERT 3D型全自动血培养仪进行培养，ATB微生物分析系统进行细菌鉴定和药敏试验。结果:从临床送检的血培养标本中共分离出病原菌76株，其中革兰阳性菌41株，革兰阴性菌31株，真菌4株，分别占53.95%、40.79%和5.26%。前5位病原菌为凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌和铜绿假单胞菌。大肠埃希菌和克雷伯菌属对碳氢酶烯类药物敏感率为100%，未发现耐万古霉素革兰阳性球菌。结论:及时监测血培养病原菌变化及耐药趋势，对指导临床用药至关重要。

Analysis of the distribution and drug resistance of pathogens in positive blood culture specimens

Objective:To investigate the distribution and drug resistance of pathogens isolated from blood culture to provide the basis in clinical rational use of antibiotics. Methods:The data of the pathogens isolated from blood culture and results of drug sensitive test were retrospectively analyzed from July 2011 to June 2012. The blood was cultured using the BACT/ALERT 3D automatic blood culture instrument. The bacteria identification and drug sensitive test were implemented using ATB expression identification system. Results:Seventy-six strains of pathogenic bacteria were isolated from clinical blood culture samples,which included 41 strains of gram-positive bacteria(53. 95%),31 strains of gram-negative bacteria(40. 79%) and 4 strains of fungi(5. 26%). The top five pathogens were the Coagulase-negative staphylococci,Escherichia coli,staphylococcus aureus,Klebsiella pneumonia and Pseudomonas aeruginosa by turn. The sensitive rate of Escherichia coli and Klebsiella penumonia to carbapenem drug was 100%,the gram-positive Cocci of vancomycin-resistant was not found. Conclusions:The timely monitoring of the pathogenic bacteria change in blood culture and trend of drug resistance are important in guiding the clinical drug use.