4238份血培养标本的病原菌分布情况及耐药性研究

目的对该院2012年6月至2016年6月血培养标本中病原菌分布情况及耐药性的研究。方法选用BD Bactec FX-200血培养分析仪对2012年6月至2016年6月共4 238份标本进行检测并对鉴定结果进行回顾性分析。结果 4 238份血培养标本中检测出阳性标本455株,阳性率为10.74%,革兰阳性菌占38.02%,革兰阴性菌占60.00%,真菌占1.98%;主要分布在新生儿和中老年患者中,分别为6.78%和76.17%。其中肠杆菌科占54.10%,以大肠埃希菌和肺炎克雷伯菌为主,非发酵菌占2.90%。革兰阳性球菌以葡萄球菌属为主,占25.87%。肠杆菌科对美罗培南、亚胺培南等较为敏感,非发酵菌对哌拉西林/他唑巴坦较为敏感,葡萄球菌和链球菌对万古霉素较为敏感。结论结合患者病原菌分布及耐药情况,临床医生应合理用药增强菌血症和真菌血症的治愈率。

Analyzed the distribution of pathogenic spectra and antibiotic resistance by isolating from 4 238 blood cultures

Objective To explore the distribution features of pathogenic spectra and antibiotic resistance of the isolates from blood cultures in hospital from June 2012 to June 2016.Methods A total of 4 238 blood samples from June 2012 to June 2016 were evaluated by BD Bactec FX-200,the identification results were used for retrospective analysis.Results A total of 455 positive pathogens were isolated from 4 238 blood cultures sample,the positive rate was 10.74％,Gram-positive accounts for 38.02％,Gram-negative bacilli accounts for 60.00％,Fungi accounts for 1.98％.Positive pathogens were distributed in newborn baby and middle-older patients,accounting for 6.78％ and 76.17％respectively.Which the Enterobacteriaceae accounting for 54.10％,the major consists were Escherichia coli and Klebsiellapneumoniae;Non-fermentative bacterial which consists of Pseudomonas aeruginosa and Acinetobacterbaumannii accounting for 2.90％.The major pathogens in Gram-positive cocci was Staphylococcus,accounting for 25.87％.Enterobacteriaceae were more sensitive to Meropenem,Imipenem and so all.Non-fermentative bacterial were more sensitive to Piperacillin/Tazobactam.Staphylococcus were more sensitive to Vancomycin and Linezolid.Streptococcus were sensitive to Vancomycin.Conclusion Combined with the distribution features of pathogenic spectra and antibiotic resistance,clinicians should pay attention to use of drugs reasonably to enhance the cure rate of bacteremia and Fungalemia.