2 308份血培养的病原菌谱及耐药性分析

目的 总结南华大学第一附属医院2年来血标本的培养结果及药敏状况, 以指导临床合理使用抗生素.方法 采用BACTEC 9050 全自动血培养仪及Vitek鉴定板和梅里埃公司药敏卡对血培养阳性标本进行菌种鉴定和药物敏感试验.结果 2 308份血标本中, 检出细菌286株, 检出率为12.4%, 其中革兰阳性菌177株, 革兰阴性菌105株, 真菌4株.革兰阳性球菌对万古霉素、米诺环素、利福平较为敏感, 而革兰阴性杆菌对美洛培南、亚胺培南、阿米卡星的敏感性较高.结论 革兰阳性球菌为本地区引起菌血症的主要病原菌, 条件致病菌表皮葡萄球菌占优势.药敏结果提示检出菌耐药性强且广谱耐药.

Distribution of Bacteria Detected From Blood Culture and Analysis of Antibiotic Resistance

Objective To investigate the composition of pathogenic bacteria in the past two years and the antimicrobialresistance of these bacteria,and to guide the clinical treatment.Methods A total of 2308 blood samples were detected by BacT/ Alert9050 automated blood culture system.Species identification and antibiotic resistance tests were performed by the VITEK automicroscan systems.Results 286 stratus were isolated from 2 308 blood samples.Positive rate was 12.4 %.Gram-positive microorganisms accounted for 61.9 %(177) of the positive blood culture results,Gram-negative microorganisms accounted for 36.7 %(105),and fungi accounted for 1.4%.The sensitive drugs of Gram-positive microorganisms were vancomycin,rifampicin,and minocyline.while the sensitive drugs of Gram-negative microorganisms were meropnem imipenem,and amikacin.Conclusion Gram-positive microorganisms was the main pathogenic bacterium in the region,the most knotty problem was the infection of neonate caused by many antimicrobial resistant bacteria.Medication should follow the result of surveillance of anti-microbial resistance.