| 吴高莉1 吴潇1 裴瑞清1 范久波2.858例血感染患者病原菌分布及耐药情况[J].,2014,14(36):7130-7133 |
| 858例血感染患者病原菌分布及耐药情况 |
| Pathogens Distribution and Drug Resistance in 858 Patients with BloodInfection |
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| DOI： |
| 中文关键词: 血培养 细菌感染 病原菌 耐药性 |
| 英文关键词: Blood culture Bacterial infections Pathogens Drug resistance |
| 基金项目:湖南省教育厅科学研究基金项目（09C149） |
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| 中文摘要: |
| 目的：通过对某地区中心医院收集的临床血感染患者感染病原菌的分析，了解该地区血感染患者病原菌构成、分布及耐药
特点，为临床治疗提供参考和指导。方法：收集2012 年6 月至2013 年8 月期间在某院就诊的858 例血感染患者血液标本，采用
BACTEC9050 全自动血培养仪培养，采用VITEK 2 Compack 系统和K-B琼脂纸片扩散法对阳性标本进行菌种鉴定和药敏检测。
结果：血培养结果显示，在858份血培养标本中共检出阳性标本109 份，每份标本都只检出一种病菌，总检出率为12.7％，革兰阳
性菌占64.22%(70/109)，革兰阴性菌占33.03%(36/109)，真菌占0.35%％(3/109)；药物敏感试验结果显示：葡萄球菌对青霉素、红霉
素和复方新诺明耐药率＞40%；肠杆菌科细菌对氨苄西林和氯霉素耐药率＞40%；非发酵菌科细菌对氨苄西林，头孢他啶，头孢噻
肟和氯霉素耐药率＞40%。结论：目前本地区临床血感染患者革兰阳性菌感染率高，以金黄色葡萄球菌和凝固酶阴性葡萄球菌为
主,治疗可以首选糖肽类抗菌药物；革兰阴性菌以大肠杆菌和绿脓杆菌为主，对氨苄西林、氯霉素耐药率高，大肠杆菌对头孢类抗
生素的耐受较绿脓杆菌低，两种细菌感染治疗可以考虑选择单环-内酰胺类抗生素。及时准确的血培养结果及药敏试验可为临床
合理选择抗菌药物提供重要依据。 |
| 英文摘要: |
| Objective:To analyze pathogenic bacteria in blood of patients with blood infection of Central Hospital so as to
understand pathogens composition, distribution and drug resistance and to provide basis for clinical treatment.Methods:Collecting 858
blood specimens from patients with blood infection from June 2012 to August 2013, using BACTEC9050 automated blood culture
system for blood specimens culture, and VITEK 2 Compack microbial systemand K-B method for strain identification and susceptibility
testing of positive blood cultures were used.Results:Blood culture results: 109 positive samples were detected in 858 specimen, only one
germ in each specimen, total detection rate for 12.7%. Gram-positive bacteria accounted for 64.22% (70/109), Gram-negative bacteria
accounted for 33.03% (36/109), fungi accounted for 0.35% (3/109); Drug sensitivity test results: Staphylococcus to penicillin,
erythromycin and cotrimoxazole resistance rate of > 40%; Enterobacteriaceae to ampicillin and chloramphenicol resistant rate of > 40%;
non-fermenting bacteria to ampicillin, ceftazidime, cefotaxime and chloramphenicol resistance rate of > 40%.Conclusion:Infection rate
of gram positive bacteria in the local clinical patients with blood infection is high, especially S.aureus and coagulase negative
staphylococcus. Treatment can be preferred glycopeptide antibiotics; Gram negative bacteria are mainly and . They
resist ampicillin and chloramphenicol highly, and we can select Single ring-lactam in the treatment. Timely and accurate results of blood
cultures and drug sensitivity test can provide important basis for reasonable selection of antibiotics. |
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