摘要
目的研究血培养中常见的革兰阴性细菌分布及耐药性,为革兰阴性菌感染的临床用药提供依据。方法 2012年10月至2015年9月临床送检血液标本分离出革兰阴性菌958株,均采用BACTEC-FX BD全自动血培养仪进行血培养,阳性标本BD全自动微生物鉴定/药敏仪Phoenix-100进行鉴定,应用WHONET5.5软件检测抗生素耐药性。结果血培养分离出革兰阴性菌958株,占前5位分别是大肠埃希菌(ECO)(23.6%)、肺炎克雷伯菌(KPN)(19.21%)、铜绿假单胞菌(PAE)(7.30%)、阴沟肠杆菌(ECL)(5.11%)、鲍曼不动杆菌(ABA)(5.00%),PAE对阿米卡星及四环素的耐药率低于2%,ABA对粘菌素的耐药率最低,敏感率为100%,ECL对亚胺培南和美罗培南的耐药率最低,为2%。产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌检出率分别为64.5%和32.6%,产ESBLs菌株的耐药率(亚胺培南、美洛培南除外)明显高于非产ESBLs菌株,差异有统计学意义(P<0.05)。结论深入了解细菌耐药特点,定期对耐药性数据进行分析,有助于了解细菌耐药性变迁,为合理使用抗菌药物提供依据。
Objective To provide the evidence for treatment of Gram-negative bacteria strains infection by investigating its distribution and drug resistance from culturing blood samples. Methods 958 strains of Gram-nega-tive bacteria isolated from October 2012 to September 2015 all used BACTEC-FX BD automatic blood culture system for culturing blood samples. The pathogens identification and resistance test were carried out by automatic microorgan-ism identification instrument （Phoenix-100 BD） , and their drug resistance was analyzed by WHONET 5. 5 software. Results 958 strains of gram negative bacteria were detected in blood culture of hospital, and the top 5 were Esche-richia coli （ECO） （23.6%）, Klebsiella pneumoniae （KPN） （19.21%）, Pseudomonas aeruginosa （PAE） （7. 30% ） , Enterobacter cloacae （ ECL） （5. 11% ） , and Acinetobacter Baumanni （ABA） （5%）. The resistance rate of PAE to Amikacin and tetracycline was less than 2%. The resistance rate of ABA to colistin was the lowest and the sensitivity rate was 100% . The resistance rate of ECL to imipenem and meropenem were the lowest, about 2% . The detection rate of extended spectrum beta lactamases （ESBLs） in ECO and KPN were 64. 5% and 32. 6% , respec-tively. The drug resistance rate of ESBLs in ECO and KPN strains of various antimicrobials （ with the exception of Imipenem and meropenem） in blood culture was higher than that non-producing ESBLs, and then the difference was statistically significant （ P 〈 0. 05 ） . Conclusion It would be helpful for the change of bacterial resistance and the rational use of antibiotics to understand the characteristics of bacterial resistance deeply and to analyze the data of drug resistance periodically.
出处
《临床肺科杂志》
2017年第10期1768-1773,共6页
Journal of Clinical Pulmonary Medicine
基金
湖北省计划生育委员会项目资助(编号sj-201209)
关键词
血培养
革兰阴性菌
耐药率
blood culture
Gram-negative bacteria
drug resistance rate
