摘要
目的了解血培养中病原菌分布及其耐药性。方法对解放军第一七四医院检验科2011年1月—2012年10月所有血培养标本按常规方法进行培养及分离鉴定；药敏方法采用标准纸片扩散法进行各种抗菌药物的体外敏感性试验。结果共分离出病原菌396株，其中革兰阳性菌占30．3％，革兰阴性菌占69．7％。最常见的分离菌依次为大肠埃希菌（26．0％）、凝固酶阴性葡萄球菌（10．6％）、肺炎克雷伯菌（9．8％）、链球菌属（8．6％）、鲍曼不动杆菌（6．8％）、金黄色葡萄球菌（6．3％）、铜绿假单胞菌（5．1％）、肠球菌属（4．8％）、嗜麦芽窄食单胞菌（4．3％）和脑膜败血金黄杆菌（4．3％）。耐甲氧西林金黄色葡萄球菌（MRSA）和耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）分别占金黄色葡萄球菌及凝固酶阴性葡萄球菌的36．0％、78．6％。葡萄球菌和链球菌属细菌中均未发现万古霉素、替考拉宁和利奈唑胺耐药菌株，粪肠球菌发现1株耐万古霉素菌株。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）的流行率分别为38．8％和12．8％，超广谱β-内酰胺酶（ESBLs）阳性大肠埃希菌对多种抗菌药物耐药率均高于ESBLs阴性细菌。鲍曼不动杆菌和铜绿假单胞菌对亚胺培南及美洛培南的耐药率分别为77．8％、77．8％和40．0％、15．0％，鲍曼不动杆菌对其他各种抗生素存在较高的耐药性（44．4％-88．9％）。结论血培养分离菌以革兰阴性菌为主，临床医生应及时了解血培养病原菌的分布特征及耐药情况，合理使用抗生素，减少医院感染。
[ Objective] To investigate the distribution and drug resistance of pathogens isolated from blood samples. [ Methods ] Blood specimens collected in Laboratory Department of the 174th Hospital of PLA from January 2011 to October 2012 were cultured and identified by routine methods, and the antimicrobial susceptibility testing was carried out by Kirby-Bauer （ K-B ） method. [ Results] A total of 396 strains were isolated from blood culture specimens, which Gram-positive bacteria and Gram-negative bacteria accounted for 30.3% and 69.7% respectively. The most frequent bacteria were E. coli （ 26.0% ）, coagulase-negative Staphylococcus （ 10.6% ）, K. pneumoniae （9.8%）, Streptococcus （ 8.6% ）, A. baumannii （6.8%）, S. aureus （6.3%）, P. aeruginosa （ 5.1% ） , Enterococcus （ 4.8% ） , S. mahophilia （4.3% ）and C. meningosepticum （ 4.3 % ）. The proportion of methicillin-resistance Staphylococcus aureus （ MRSA ） to S. aureus and methicillin-resistance coagulase-negative Staphylococcus （ MRCNS ） to coagulase-negative Staphylococcus was 36.0% and 78.6% respectively. No strain was found resistant to vancomycin, teicoplanin and linezolid in Staphylococcus and Streptococcu, and a vancomycin-resistant strain was found in E. faecalis. The percentage of extended spectrum β-lactamases （ ESBLs）-producing E. coli and ESBLs-producing K. pneurnoniae was 38.8% and 12.8% respectively. ESBLs producing E. coli bacteria showed higher resistance rate than non-ESBLs producing strains. The drug resistance rates of A. baumannii and P. aeruginosa to imipenem and meropenem were 77.8%, 7.8% and 40.0%, 15.0%, respectively. A. baumannii strains were highly resistant to other antibiotics （44.4%-88.9% ）. [ Conclusion] The most common isolates from blood culture are Gram-negative bacteria. The clinical doctors should know the distribution and drug resistance of pathogens in time, so as to properly use antibiotics and reduce the nosocomial infection.
出处
《职业与健康》
CAS
2013年第17期2167-2170,共4页
Occupation and Health
关键词
血培养
耐药性
病原菌
Blood culture
Drug resistance
Pathogen
