摘要
目的:分析3年期间医院血培养病原菌的分布及耐药性,以指导临床用药。方法:回顾分析医院2009-09-2012-08血培养标本培养鉴定和药敏结果。结果:共分离血培养病原菌571株,其中革兰阳性菌338株(59.19%),革兰阴性菌232株(39.63%),真菌1株,前4位细菌分别是凝固酶阴性葡萄球菌(CNS)、大肠埃希菌(E.coli)、肺炎克雷伯菌(Kpn)、金黄色葡萄球菌(Sau);耐甲氧西林金黄色葡萄球菌(MRSA)占Sau14.3%,E.coli和Kpn产超广谱β-内酰胺酶(ESBLs)为57.0%和24.0%,耐亚胺培南E.coli2株;碳青霉烯类抗菌素、阿米卡星、哌拉西林/他唑巴坦对革兰阴性菌敏感率达92.5%以上,其他抗菌药物敏感性降低;葡萄球菌对喹努普汀/达福普汀、利奈唑胺、莫西沙星和替加环素高度敏感,血流感染的金黄色葡萄球菌青霉素和四环素敏感率低,其他14种抗菌药物敏感率70%以上;肠球菌和链球菌对克林霉素、红霉素和四环素耐药率高。结论:血培养病原菌以革兰阳性菌为主,CNS占重要地位,出现耐亚胺培南大肠埃希菌。血培养细菌耐药情况严重,应及时监测耐药情况以指导临床用药。
Objective：To study the distribution and antimicrobial resistance of pathogens isolated from blood culture in our hospital from 2009 to 2012. Method：Data of pathogenic bacteria identification and bacterial susceptibility test of blood culture from 2009 to 2012 were analyzed,retrospectively. Result：A total of 571 pathogens were isolated from blood cultures, the stains of gram-positive were 338 （59.19 % ）, gram-negative 232 （40.63 % ） and fungi was 1. The four most frequent isolated pathogens were Coagulase negative Staphylococcus（CNS）, Escherichia coli （E. colD,Klebsiella pneumoniae（Kpn） and Staphylococcus aureus（Sau）. Methicillin-resistant Staphylococcus aureus（MRSA） was 14.3% in Sau. Extended-spectrum β-lactamase enzymes（ESBLs） were detected in 57.0% of the E. coli and 24.0% of the K. pneumoniae. Imipenem resistance of E. coli were 2. The sensitivities of Carbapenems, Amikacin,Piperacillin and Tazobactam to Gram-negative bacteria were all up to 92.5% ,while the sensitivity of other antibacterial drugs reduced. The sensitivities of Staphylococcus to Quinupristin/Dalfopristin, Linezolid, Moxi- floxacin and Tigecycline were high. Penicillin and Tetracycline had lower sensitivity to S. aureus of blood stream; while sensitivity of other 14 antibacterial drugs were up to 70%. The Enterococcus and Streptococcus had higher resistance to Clindamycin Erythromycin and Tetracycline. Conclusion：Gram-positive Cocci（especially CNS） was an important stain in blood stream infection. Imipenem resistance of E. coli was isolated. Antimicrobial resistance of pathogens isolated from blood culture was prevalent and serious. Our study highlighted the need for monitoring the change of pathogens and antimicrobial resistance for guiding the clinical therapy.
出处
《临床血液学杂志（输血与检验）》
CAS
2013年第2期234-237,共4页
Journal of Clinical Hematology(Blood Transfusion & Laboratory Medicine)
关键词
血培养
耐药性
病原菌
耐甲氧西林金黄色葡萄球菌
blood culture
drug resistance
pathogens
methicillin-resistant staphylococcus aureus
