西安地区血培养标本病原菌分布及耐药性分析

目的了解收集的西安地区住院与门诊患者血培养标本中病原菌分布及耐药性。方法对收集的2005年1月至2008年12月7 527份血标本经BACTEC 9050全自动血培养仪培养,检出病原菌后用Vitek-32微生物鉴定仪进行病原菌鉴定和K-B法进行药敏试验。结果共检出828株病原菌。其中革兰阳性菌492株(59.4%),革兰阴性菌318株(38.4%),真菌18株(2.2%),并分别检出ESBLs大肠埃希菌及肺炎克雷伯菌26株和5株。凝固酶阴性葡萄球菌和金黄色葡萄球菌对青霉素耐药率较高,分别为85.3%和87.3%,对万古霉素耐药率均最低(0.0%)。大肠埃希菌和肺炎克雷伯菌对亚胺培南、头孢吡肟耐药率较低(0.0%~10.5%);铜绿假单胞菌对亚胺培南的耐药率最低(10.4%),对头孢唑啉的耐药率最高(89.8%)。结论血培养中分离出的病原菌种类复杂,耐药率各不相同,应对血培养标本病原菌加强监测,指导抗菌药物合理应用。

Distribution and drug resistance of blood culture pathogenic bacteria in Xi'an area

Objective To investigate bacteria distribution and drug resistance of inpatient and outpatient in Xi′an area.Methods 7 527 blood samples from January 2005 to December 2008 were cultured by BACTEC 9050 automated blood culture system.The pathogenic bacteris which were detected were identified by Vitek-32 system and drug sensitive test was made by K-B disk method.Results Eight hundred and twenty-eight pathogenic bacteria were detected,which include gram-positive bacteria 492(59.4%),Gram-negative bacteria 318(38.4%),fungal 18(2.2%).And producing extended spectrum β lactamases(ESBLs) Escherichia coli and Klebsiella pneumoniae were 26 and 5.The resistance rates of coagulase negative staphylococcus and staphylococcus aureus to penicillin were 85.3% and 87.3% respectively,but the resistance rates of them to vancomycin was the lowest(0.0%).The resistance rates of Escherichia coli and Klebsiella pneumoniae to imipenem and cefepime were low(0.0%-10.5%),the resistance rates of Pseudomonas aeruginosa to imipenem was the lowest(10.4%),but to cephazolin was the highest(89.8%).Conclusion The species of isolated bacteria are complicated from the blood cultures and their drug resistance rates were different.Blood culture and monitoring of drug resistance should be paid attention in order to guide the application of antibacterials reasonably.