248株血液标本检出细菌临床特征及耐药性分析

目的了解血液感染常见细菌分布及耐药特点，为临床血液感染治疗提供实验依据。 方法回顾性分析2010年3月至2013年10月临床阳性血培养资料。 结果共检出细菌248株，分离率排前3位的依次是大肠埃希菌（40.73%）、表皮葡萄球菌（19.76%）和肺炎克雷伯菌（9.27%）。产超广谱β-内酰胺酶（ESBLs）的大肠埃希菌及肺炎克雷伯菌检出率分别为44.55%和20.69%，产酶菌株耐药性严重，检出亚胺培南耐药和美罗培南耐药的大肠埃希菌。甲氧西林耐药金黄色葡萄球菌（MRSA）和甲氧西林耐药表皮葡萄球菌（MRSE）检出率分别为46.67%和69.39%，未发现万古霉素、替考拉宁耐药菌株，葡萄球菌耐药率较低的药物还有利奈唑胺和奎奴普丁-达福普丁。 结论血液感染细菌以肠杆菌科细菌为主，敏感药物为碳青霉烯类。应加强血液感染监测，及时了解其病原菌分布与耐药特点，制定有效的抗菌治疗方案，提高治愈率。

Analysis on clinical characteristic and drug resistance of 248 strains bacteria from blood samples

ObjectiveTo investigate the distribution and drug resistance of pathogenic bacteria from blood, and to provide experiment basis for clinical treatment of bloodstream infection. MethodsPositive blood culture from March 2010 to October 2013 were analyzed, retrospectively. ResultsTotal of 248 strains were isolated from blood samples, the top 3 groups were E. coli (40.73%), S. epidermidis (19.76%) and K. pneumoniae (9.27%). ESBLs were produced in 44.55% of E. coli and 20.69% of K. pneumonia, respectively. The resistant rates of ESBLs positive strains were higher than those non-ESBLs-produced strains. E. coli strains of drug-resistance to imipenem and meropenem were detected. The isolated rate of MRSA and MRSE accounted for 46.67% and 69.39%, respectively. None of Gram-positive cocci was resisitant to vancomycin and teicoplanin, and linezolid and quinupristin/dalfopristin were also with lower Staphylococcus resistant rate. ConclusionsEnterobacteriaceae bacteria were the common pathogens in blood infection, and the highest sensitive drug was carbapenems. Blood infection surveillance should be strengthened so as to understand the distribution and drug resistance of pathogenic, and to develop the effective treatment program and improve the cure rate.