某院2012—2013年血培养病原菌分布及耐药性分析

目的：分析我院2012年1月--2013年7月血培养病原菌分布及耐药性。方法：用BACTEC9120血培养仪，细菌及真菌鉴定使用API系统及MicroScan鉴定系统，药物敏感试验用纸片扩散法（KB法）及肉汤稀释法，药敏结果判断和解释参照抗菌药物敏感试验执行标准（CLSI2010版），采用wHONET5．4软件统计分析。结果：7415份标本检出病原菌641株，阳性率为8．64％。2012年检出病原菌374株，其中革兰阳性球菌188株，革兰阴性杆菌162株，真菌24株。2013年检出病原菌267株，其中革兰阳性球菌134株，革兰阴性杆菌120株，真菌13株。金黄色葡萄球菌和表皮葡萄球菌对利奈唑烷、万古霉素、达托霉素敏感率为100％；大肠埃希菌和肺炎克雷伯菌对亚胺培南敏感率为100％。结论：2012年1月-2013年7月血培养病原菌检出病原菌种类多、分布广且耐药性较严重。但大部分抗菌药物耐药率2013年比2012年低（P〈0．005），说明我院从2010年开始进行抗生素规范使用，已对控制细菌耐药产生重要影响，并初步取得成果。

Distribution and Drug Resistance Analysis of Pathogenic Bacteria in Blood Samples in Our Hospital From 2012 to 2013

Objective： To analysis the distribution and drug resistance of pathogenic bacteria in blood culture in central hospital of Nanchong from 2012 to July 2013. Methods： Blood samples were cultivated with BACTEC9120 Blood culture system,bacteria and fungi were identified with API system and MicroScan identification system, drug sensitivity test was taken with KB method and Broth dilution method. Judgment and interpretation were reference to the implementa- tion of standards （CLSI 2010）, the test results were analyzed with WHONET 5. 4 software. Results： Among the 7 415 clinical blood samples, 641 strains of pathogenic bacteria were isolated, the positive rate was 8. 64%. 374 strains of pathogenic bacteria were isolated in 2012,Gram-positive cocci were 188 strains,Gram-negative bacilli were 162 strains, fungi were 24 stains. 267 strains of pathogenic bacteria were isolated in 2013, Gram-positive cocci were 134 strains, Gram-negative bacilli were 120 strains, fungi were 13 stains. Staphylococcus aureus and Staphylococcus epidermidis were sensitive （100%） to Linezolid, Vancomycin and Daptomycin. Escherichia coli and Klebsiella pneumoniae were sensitive （100%） to Imipenen-u Conclusion：From January 2012 to July 2013 blood culture pathogens were detected Spe- cies, widely distributed and more serious resistance. But most antimicrobial resistance rates were lower in 2013 than 2012（P〈0. 005）, the explanation was that our hospital began to regulate the use of antibiotic from 2010, and it has im- portant impact on the control of bacterial resistance, and preliminary results achieved.