罗江地区血培养标本病原菌种类及耐药性分析

目的探讨1450例血培养标本的病原菌种类及耐药性，为经验性抗生素使用提供依据。方法回顾性分析2009年12月至2012年12月1450例血培养标本的细菌种类以及抗药性。细菌培养采用Bactectm9120型全自动血培养仪，细菌鉴定采用手工法。药敏试验采用MIc法。结果1450例血标本共检出274株病原菌。其中主要革兰阴性茵为大肠埃希菌33．6％（92／274）、肺炎克雷伯菌18．2％（50／274）；主要革兰阳性菌为金黄色葡萄球菌15．0％（41／274）和表皮葡萄球菌10．2％（28／274）。其中25．2％（69／274）例细菌耐药，革兰阴性菌43例，革兰阳性菌26例。对革兰阴性菌敏感性较高的药物为亚胺培南、美洛培南、阿米卡星、头孢哌酮／舒巴坦、哌拉西林／他唑巴坦：对革兰阳性菌敏感性较高的药物为万古霉素、替考拉宁、利奈唑胺。结论血标本中主要分离细菌为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌以及表皮葡萄球菌。临床经验用药可选择上述细菌敏感的药物。

Analysis of pathogens detected from blood culture samples and its drug resistance in Luojiang district

Objective To analyze the 1 450 pathogens detected from blood cuhure samples and the drug resistance to provide basis for administration of empiric antibiotics. Methods A total of 1 450 cases of bacterial species during December 2009 to December 2012 and the drug resistance were analyzed retrospectively. Pathogens were cultured by Bactectm 9120 full- automatic blood culture machine and identified by manual. The method of minimal inhibitory concentration （MIC） was used for drug sensitive test. Results 274 strains of pathogenic bacteria were isolated from 1 450 blood samples. The gram-negative bac- teria were mainly Escherichia coli （E. coli） （33.6%, 92/274） and Klebsiella pneumoniae （ 18.2%, 50/274） ; the gram-positive bacteria were mainly Staphylococcus aureus （ 15.0%, 41/274） and Staphylococcus epiderulidis （ 10.2%, 28/274）. Drug-resistance bacteria accounted for 25.2% （69/274）,43 cases of which were gram-negative bacteria and 26 cases were gram-positive bacteria. The drugs were high sensitivity to gram-negative bacteria were imipenem,meropenem,Amikacin,Cefoperazone/sulbactam, piperaeillin/tazobactam ;while the drugs with high sensitivity to gram-positive bacteria were Vancomycin, teicoplanin and linezolid. Conclusion The main bacteria isolated from the blood specimens are E. coli, Klebsiella pneumonia, Staphylococcus aurcus and Staphylococcus epidermidis. Above drugs with bacterial sensitivity can be chosen as the experienced clinical application of an- tibiotics.