恶性肿瘤患者血培养菌群分布及耐药性分析

目的:通过整理和分析血流感染患者病原菌的构成、分布及耐药特点,为临床血流感染的诊治及抗菌药物的合理应用提供重要依据.方法:分析2014年至2015年2287份血培养标本,采用BACT/ALERT 3D 60血培养仪,运用ATB Expression微生物鉴定及药敏分析仪进行病原菌鉴定及药敏试验.结果:本次调查的2287份血培养标本中共检出阳性标本258份,检出率为11.28%.其中,革兰阳性菌占35.52%,革兰阴性菌占61.78%,真菌占1.93%,专性厌氧菌占0.77%.耐甲氧西林金黄色葡萄球菌(MRSA)占22.73%(5/22),耐甲氧西林凝固酶阴性葡萄球菌(MRCNS)占63.27%(31/49),大肠埃希菌、肺炎克雷伯菌对亚胺培南、美罗培南敏感率100%,而对阿莫西林、替卡西林、哌拉西林及头孢类抗菌药物有较高的耐药性.结论:引起血流感染的病原菌以革兰阴性菌为主,临床应及时了解病原菌的分布及药敏的监测,可以选择更有效的抗菌药物,从而减少耐药菌株的产生.

Analysis of distribution and drug resistance of blood culture bacteria in patients with ma-lignant tumor

Objective:To provide an important basis for clinical diagnosis,treatment and rational use of antimicro-bial agents,the composition,distribution and drug resistance of pathogenic bacteria in hospital from 2014 to 2015.Methods:The data of 2287 blood culture samples were analyzed used BACT/ ALERT 3D 60 blood culture instru-ment,used Expression ATB microbial identification and drug sensitivity analysis of pathogenic bacteria identification and drug sensitivity test.Results:2287 blood samples were detected in 258 samples of blood culture,the positive rate was 11.28% .Among them,gram positive bacteria accounted for 35 .52 % ,gram negative bacteria accounted for 61.78%,fungi accounted for 1.93%,special anaerobic bacteria accounted for 0.77% .Resistance of methicillin-re-sistant Staphylococcus aureus (MRSA)22.73%(5/ 22)]and resistant to methicillin resistant coagulase negative staphylococci (MRCNS)63.27%(31/ 49),Escherichia coli,pneumonia Klebsiella pneumoniae strains to imipenem, meropenem sensitive rate were 100%,and amoxicillin,ticarcillin,piperacillin,pull penicillin and cephalosporin class antimicrobial drugs had higher.Conclusion:The main pathogens of bloodstream infections are Gram-negative bacte-ria,which could be used to understand the distribution of pathogenic bacteria and the monitoring of drug sensitivity in a timely manner,so as to select more effective antimicrobial agents,and to reduce the production of drug resistant strains.