血培养常见病原菌分布和耐药性分析

目的 了解血培养常见病原菌的分布和耐药情况.方法 在5054份血培养标本中收集非重复分离株674株,其中革兰阳性菌63.2%,革兰阴性菌34.9%,真菌1.9%.以CLSI推荐的纸片扩散法测定其抗菌药物敏感性,用WHONET 5.4软件分析结果.结果 5054例血培养中,分离非重复株674,阳性率为13.3%.主要病原菌有凝固酶阴性葡萄球菌、大肠埃希菌、金黄色葡萄球菌、肠球菌、链球菌、肺炎克雷伯菌等.其中耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）占凝固酶阴性葡萄球菌的83%,耐甲氧西林金黄色葡萄球菌（MRSA）占金黄色葡萄球菌的61.2%,未发现耐万古霉素的葡萄球菌,大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）的菌株分别为63.8%和35.5%,分离出13株真菌.高耐氨基甙类肠球菌（HLGR）检出率为58.1%,分离到耐万古霉素的肠球菌.结论 血培养中病原菌复杂多样,耐药率高,及时监测血培养中病原菌的耐药性对于指导临床合理用药、防止滥用抗生素、减少耐药菌株的产生是很有必要的.

Common pathogenic bacteria distribution and drug resistance analysis in blood culture

Objective To study distribution and drug resistance situation of pathogenic bacteria isolated from blood culture. Methoas A total of 5054 nonduplicate isolates were collected from blood culture,of which 63.2% were gram- positive strains and 34.9% were gram - negative strains. The susceptibility was tested by disk diffusion method as recommended by CLSI.All the data were analyzed by WHONET 5.4 software. Results Totally 674 nonduphcate strains of bacteria were isolated from 5054 blood samples, positive rate was 13.3 %. Coagulase negative Staphylococcus, E. coli, Staphylococcus anxens, Enterococcus sp., Streptococcus sp., K. pneumonzae were dominant, among MRCNS were 83% and MRSA were 61.2%. None VRSA were isolated. ESBLs producing strains of Eseherichia eoli and Klibaiella pneumonJae rate were 63.8% and 35.5%. 13 strains fungi were isolated. High - level gentamicin resistance （HLGR） rate were 58. 1%, VRE were isolated. Conclusion Types of bacteria in blood infection were complicate , and they were resistant severely to antibiotics, it suggested that antibiotics must be reasonably applied to reduce resistant pathogenic bacteria to be produced and enhance clinical therapy effect according to the result of blood culture.