摘要
目的:观察血培养检出菌变迁的规律以及耐药性。方法:总结1998年至2007年间北京安贞医院血培养178株检出菌及药敏结果。结果:主要以凝固酶阴性葡萄球菌(CNS)为首;CNS和金黄色葡萄球菌对多种抗生素耐药率达60%以上,目前尚未发现对万古霉素耐药菌株;在大肠埃希氏菌、阴沟肠杆菌及克雷伯杆菌中,目前尚未发现耐亚胺培南的菌株;但在非发酵菌中,有52.9%的菌株对亚胺培南耐药。结论:凝固酶阴性葡萄球菌是血培养常见菌株;万古霉素是有效的抗葡萄球菌药物;对于大肠埃希氏菌、阴沟肠杆菌及克雷伯杆菌,亚胺培南仍是最有效的抗生素;真菌感染应值得关注。
Objective：To investigate the changes of bacteria detected from blood culture and results of antibiotic resistance and to explore for clinical diagnosis and treatment information.Methods：178 bacterial isolates were obtained from blood culture and results of antibiotic resistance were analyzed.BioMerieux＇s aerobic and anaerobic blood culture bottles and the company＇s Bact/Alert-120 automated blood culture system were used for culture.BioMérieux VITEK-Jr automatic bacteria identification device was used for identification,and the company GNI identification card and GNS-133 were used for drug susceptibility,the United States for Clinical Laboratory Standards Institute（CLSI） standard judgments based on.SPSS11.0 statistical software package was used.The number of bacterial resistance to antibiotics was expressed by the percentage and cases and using χ2 test for fourfold table.P 0.05 act as statistically significant difference.Results：30 species of bacteria were detected in 178 strains,including Gram-positive（G ＋） cocci 102,Gram-negative（G-） bacilli 45,Grampositive bacteria 3,fungi 28.Including Staphylococcus aureus,Staphylococcus epidermidis of 23;Candida albicans 17;Staphylococcus haemolyticus 16;Enterococcus faecalis 13;Enterococcus faecium 12;Enterobacter cloacae 11;Pseudomonas aeruginosa 9;Acinetobacter baumannii,Candida glabrata each eight;Stenotrophomonas maltophilia 5;Klebsiella spp,Staphylococcus sciuri each four;Escherichia coli,Streptococcus mutans,Streptococcus oralis each three;Candida tropicalis,Chrysemonas luteola,Bacillus perfringens each two;Streptococcus salivarius,Listeria,Streptococcus mitis,Streptococcus bovis,Burkholderia cepacia,Bacillus brevis,Staphlococcus lentus,Staphlococcus simulans,Enterococcus gallinarum,Sauharoyces cerevisiae each one.During the 10 years,the G ＋ accounts for majority and five times the component ratio of Coagulase negative Staphylococci（CNS） was largest in the past ten years.The component ratio of streptococcus was falling off obviously since 2001.The component ratio of non-fermenting bacteria was largest at 2001 and 2005.Two times the component ratio of fungus was largest during the 10 years.Many kinds of antibiotic resistance rate are more than 60% in CNS and Staphylococcus aureus.In the above two types of bacteria there are not found vancomycin-resistant strains in our study.In Escherichia Klebsiella,Enterobacter cloacae,Klebsiella,there are not found imipenem-resistant strains.However,in non-fermentative bacteria,there are 52.9% of strains resistant to imipenem and the resistance rates of ceftazidime was less than ceftriaxone.In this study 12 strains of Enterococcus faecium and 13 stains of Enterococcus faecalis were found and accounted for the Enterococcus 46.2%,50.0% respectively.In this study,the resistance rate of Enterococcus faecalis to penicillin,ciprofloxacin,levofloxacin was 14.3%,42.9% and 50.0%,while the resistance rate of Enterococcus faecium was 70.0%,75.0% and 87.5% respectively.The resistance rate of Enterococcus faecium was significantly higher than that of Enterococcus faecalis During the 28 fungi strains,the number of cases detected each year 0,0,2,2,4,2,2,5,5 and 6 respectively.The past three years the number of detected cases has increased over the previous accounting for 57.1% of the total number of fungi.Conclusion：Coagulase-negative staphylococci is common blood culture isolate.At present,vancomycin is very effective antistaphylococcal drug.In Escherichia Klebsiella,Enterobacter cloacae,Klebsiella,imipenem remains the most effective.Fungal infections become a serious problem more and more.
出处
《心肺血管病杂志》
CAS
2010年第5期388-390,427,共4页
Journal of Cardiovascular and Pulmonary Diseases
关键词
血培养
病原菌
耐药性
抗生素
心血管疾病
Blood culture
Pathogens
Drug resistance
Antibiotics
Heart diseases
