摘要
目的:研究医院血流感染病原菌的菌种分布及耐药情况,为临床抗感染治疗提供实验室依据。方法:采用BACTEC FX400全自动血培养仪进行血培养,Phoenix100自动微生物鉴定/药敏系统进行鉴定和药敏试验,结果判读参照CLSI2014标准,采用WHONET 5.6软件对结果进行统计分析。结果:19 284份血液标本中共分离出病原菌2 063株,检出阳性率为10.7%,其中革兰阳性菌1 051株占50.9%,革兰阴性菌958株占46.4%,真菌40株占1.9%,厌氧菌14株占0.7%,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)的检出率分别为47.9%和65.0%,葡萄球菌属对万古霉素、替考拉宁、利奈唑胺高度敏感,产ESBLs大肠埃希菌和肺炎克雷伯菌检出率分别为64.5%和32.6%,碳青霉烯类对大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌有较好的抗菌活性,鲍曼不动杆菌对各类抗菌药物耐药性较高。结论:血流感染的病原菌种类复杂、耐药率高,应加强血培养中病原菌的耐药性监测,合理指导临床使用抗菌药物。
Objective：To investigate the distribution and drug resistance of pathogenic bacteria from blood- stream infection and provide laboratory evidence for clinical anti-infection treatment. Methods. BACTEC FX400 automatic blood culture system was used for blood culture, and Phoenix100 bacteria identification system was adopted for bacteria identification and drug susceptibility test. The results were interpreted according to CLSI 2014 and analysed with WHONET5.6 software. Results. A total of 2 063 strains of pathogens were isolated from 19 284 blood culture samples with the positive rate of 10. 7 %, including 1 051 strains of gram-positivebacteria （50. 9 % ）, 958 strains of gram-negative bacteria （50.9 %）, 40 strains of fungi（1.9%）,and 14 strains of anaerobion（0.7%）. The detection rates of MRSA and MRCNS were 47.9% and 65.0% respectively. Staphylococcus was highly susceptible to vancomycin, teicoplanin and linezolid,The ESBLs-producing E. coli and K. pneumoniae strains accounted for 47.9% and 65.0% re- spectively. Carbopenems had favorable antibacterial activity against Enterococcus, K. pneumoniae and Pseudomonas aeruginosa. Acinetobacter baurnannii were resistant to various antibiotics. Conclusion. The pathogenic spectra of bloodstream infection are complex and the rate of resistance is high, so that the drug resistance of the pathogens in blood culture should be reinforced for the guidance of proper use of antibi- otics in clinical practice.
出处
《武汉大学学报（医学版）》
CAS
2016年第5期845-848,860,共5页
Medical Journal of Wuhan University
关键词
血培养
病原菌
耐药性
Blood Culture
Pathogen
Drug Resistance
