3644瓶阳性血培养病原菌分析及双份血培养意义评价

目的了解阳性血培养的病原菌分布和双份血培养对病原菌分布及检出率的影响。方法采用自动血培养仪对2004年1月~2008年6月送检的36 689瓶标本进行培养,对阳性的标本进行病原菌统计分析。结果共检出阳性标本3644瓶2977株,最多见的病原菌为凝固酶阴性葡萄球菌563株(18.9%),其次分别为大肠埃希菌320株(10.7%)、金黄色葡萄球菌252株(8.5%)、肺炎克雷伯菌154株(5.2%)、酿脓链球菌153株(5.1%);检出的真菌共284株(9.5%),其中白色假丝酵母菌最为常见,占37.7%;共送检双份血培养9118瓶,检出阳性1080瓶,检出率为11.8%,双份血培养的病原菌检出率高于单份血培养的检出率,差异有统计学意义(P0.05);双份血培养均阳性和双份血培养中单瓶阳性的病原菌分布也有明显的差异。结论血培养中革兰阳性球菌是最常见的细菌,真菌作为血流感染病原菌的机会增多,需予以重视,鉴于双份血培养具有提高培养检出率和一定鉴别污染的能力,需常规开展双份血培养送检工作。

Etiology of Positive Blood Cultures and Effectiveness of Collecting Double Sets of Blood Cultures

OBJECTIVE To identify the pathogen distribution of blood culture and evaluate the clinical significance of collecting gouble sets of blood cultures.METHODS A total of 36689 bottles of blood culture were performed from Jan 2004 to Jun 2008 using automated detection system, and the pathogens of positive blood culture were analyzed.RESULTS From them 3644 bottles of positive blood cultures occurred during the study period.The most common strains were coagulase-nagetive staphylococcus (18.9%), followed by Escherichia coli (10.7%), Staph-ylococcus aureus (8.5%), Klebsiella pneumoniae (5.2%) and Streptococcus pyogenes (5.1%).All together, we carried out 284 strains of fungi, Candida albicans was the most frequent isolates (37.7%).During the study period, 9118 cases collected gouble sets or more blood cultures per episode, the isolating rate was 11.8%, which was significantly higher than the single one (P<0.05).The distribution of pathogens between single set blood culture and gouble ones was totally different.CONCLUSIONS The most common bacteria of blood culture are Gram-positive cocci.Fungi infection in blood stream are increasing.Because collecting gouble sets of blood cultures can significantly increase the isolating rates and distinguish contamination from real bloodstream infection, collecting gouble sets of blood cultures should be recommended.