651株血培养病原菌分布及耐药性分析

目的：分析血培养阳性标本中的病原菌种类及耐药状况,为临床合理应用抗菌药物提供依据.方法：采用BacT/Alert 3D全自动血培养仪培养血标本,并使用ATB expression微生物鉴定系统对细菌及真菌进行鉴定,药敏试验用K-B纸片法,数据分析用WHONET 5.6软件.结果：分离血培养病原菌651株,其中革兰阳性菌324株（49.8％）,革兰阴性菌279株（42.9％）,真菌48株（7.4％）,前4位细菌分别为凝固酶阴性葡萄球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌,大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物100％敏感,对其他抗菌药物有不同程度的耐药;未发现对万古霉素耐药葡萄球菌.结论：临床医生应高度重视血培养,根据药敏结果合理使用抗菌药物,减少耐药菌株的产生.

Pathogen distribution of 651 strains of blood culture and the analysis of their drug resistance

Objective： To analyze the the species of pathogenic bacteria and the drug resistance of the positive blood culture, so as to provide evidence for the clinical rational use of antibiotics. Methods： Blood samples were cultured by BacT/Alert 3D automatic blood culture instrument, the bacterial identity were tested by using ATB expression microbe analysis instrument, the drug sensitivity tests were performed by K-B diffusion method, and the data were analyzed by WHONET 5.6 software. Results： A total of 651 strains of pathogens were isolated from blood cultures, of which, there were 324 stains of gram-positive bacteria （49.8 %）, 279 strains of gram-negative bacteria （42.9 %）, and 48 stains of fungi （7.4%）. The ranked top four frequent isolated bacteria were coagulase negative staphylococcus, escherichia coli, klebsiella pneumoniae and staphylococcus aureus respectively. Escherichia coli and klebsiella pneumoniae were ied resistance to other drugs. And it found that 100% sensitive to carbopenems,but exhibited varstaphylococcus was 100% sensitive to vancomycin.Conclusion： Clinical doctors should pay great attention to the blood culture and apply reasonably the antibiotics to patents according to drug sensitivity results so as to reduce the the resistant strains.