1783份血培养致病菌的分离及其阳性结果的临床分析

目的分析1998～2003年间从血培养标本中分离出的致病菌的分布特点并对其引起败血症的临床危险因素进行探讨.方法无菌抽取临床疑似败血症的病人血液5～10 ml,注入法国生物-梅里埃的液固双相培养瓶中,对培养阳性标本进行常规细菌鉴定,其药敏试验采用K-B法.收集阳性标本的临床资料进行回顾性分析.结果6年中从1783份血培养标本中分离出致病菌191株,阳性检出率为10.7%.其中革兰阳性菌占51.3%(98/191),主要分离自新生儿败血症标本;革兰阴性菌占45.5%(87/191),主要分离自原发病或伴随疾病标本;真菌占3.2%(6/191),主要分离自静脉插管和ICU标本.结论血培养标本中分离出的主要致病菌为凝固酶阴性的葡萄球菌、伤寒沙门菌、大肠埃希菌、金黄色葡萄球菌、假单胞菌属.危险因素与免疫功能不全、介入性治疗、广谱抗生素及免疫抑制剂的广泛应用有关.致病菌引起的败血症死亡率高.为降低病死率,临床医生应高度重视血培养的检测及导致败血症的临床相关危险因素.

The Clinical Analysis of Pathogens Isolation and Positive Findings in 1783 Cases of Blood Culture

Objective To probe the characteristics of pathogens distribution and clinical risk factors associated with septicemia Methods 1 783 cases of blood culture from 1998 to 2003 were collected Blood from patients who were suspected with septicemia was sterile drawn,and cultured by traditional method,positive samples and pathogens were identified,while drug sensitive test was carried out with K-B method The clinical data were collected and retrospective analysis was performed Results 191 strains of pathogens were isolated from 1 783 blood samples,and positive rates was 10 7%;gram-positive bacteria was 51 3% and was mainly from samples of newly born babies with septicemia;gram-negative bacteria was 45 5%(87/191)and mainly from samples of primary diseases and accompanying diseases;fungi was 3 2%(6/191)and was mainly from samples of venous cannulation and ICU Conclusion The main pathogens isolated from blood samples of our hospital might be coagulase-negative staphylococcus,Salmonella typhi,Escherichia coli,staphylococcus aureus and pseudomonas,risk factors are associated with immunological insufficiency,invasive treatment,extensive application of wide-range antibiotics and immunosuppressive agents Septicemia caused by pathogens contribute to high mortality,and clinical doctor should put emphasis on blood culture monitoring and clinical risk factor associated with septicemia in order to reducing fatality rate