医学检验与临床
醫學檢驗與臨床
의학검험여림상
MEDICAL LATORATORY SCIENCE AND CLINICES
2013年
6期
39-42
,共4页
叶刚强%麦炳汉%苏丹虹%韦世强%谢冠荣%李毅
葉剛彊%麥炳漢%囌丹虹%韋世彊%謝冠榮%李毅
협강강%맥병한%소단홍%위세강%사관영%리의
血培养%耐药性%病原菌%血流感染
血培養%耐藥性%病原菌%血流感染
혈배양%내약성%병원균%혈류감염
Blood culture%Drug resistance%Pathogenic bacteria%Bloodstream infection
目的：了解我院2006～2008年血培养阳性标本的病原菌分布和耐药性变迁。方法：采用BacT/Alert3D血培养仪及Vitek-2鉴定仪，对住院患者的血培养标本进行病原菌培养鉴定试验。细菌药物敏感性试验采用纸片扩散法(K-B法)；选用WHONET5.4软件进行统计分析。结果：2006～2008年共分离出病原菌298株，其中革兰阴性菌所占比例分别为64.1%、52.1%和54.8%；革兰阳性菌所占比例分别为36%、47.9%和46%。血培养阳性检出率主要分布于血液科27.1%、中心监护室13.4%、儿科9.4%、泌尿外科6.1%和呼吸内科5%。细菌检出率较高的革兰阴性菌主要以大肠埃希菌、铜绿假单胞菌、肺炎克雷伯菌为主；大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶( ESBLs)流行率分别为44.9%(22/49)和26.3%(5/19)，革兰阴性菌对碳青酶烯类抗菌药物仍保持较高的敏感性。检出率较高的革兰阳性菌主要以金黄色葡萄球菌、表皮葡萄球菌和人葡萄球菌。在葡萄球菌和肠球菌中均未发现对万古霉素和替考拉宁的耐药菌株。结论：本院血培养阳性结果中条件致病菌所占比例及其耐药性较高，临床医生应及时了解血培养阳性病原菌的分布特征及耐药情况，合理使用抗生素，减少医院内感染及血流感染败血症的死亡率。
目的：瞭解我院2006～2008年血培養暘性標本的病原菌分佈和耐藥性變遷。方法：採用BacT/Alert3D血培養儀及Vitek-2鑒定儀，對住院患者的血培養標本進行病原菌培養鑒定試驗。細菌藥物敏感性試驗採用紙片擴散法(K-B法)；選用WHONET5.4軟件進行統計分析。結果：2006～2008年共分離齣病原菌298株，其中革蘭陰性菌所佔比例分彆為64.1%、52.1%和54.8%；革蘭暘性菌所佔比例分彆為36%、47.9%和46%。血培養暘性檢齣率主要分佈于血液科27.1%、中心鑑護室13.4%、兒科9.4%、泌尿外科6.1%和呼吸內科5%。細菌檢齣率較高的革蘭陰性菌主要以大腸埃希菌、銅綠假單胞菌、肺炎剋雷伯菌為主；大腸埃希菌和肺炎剋雷伯菌產超廣譜β-內酰胺酶( ESBLs)流行率分彆為44.9%(22/49)和26.3%(5/19)，革蘭陰性菌對碳青酶烯類抗菌藥物仍保持較高的敏感性。檢齣率較高的革蘭暘性菌主要以金黃色葡萄毬菌、錶皮葡萄毬菌和人葡萄毬菌。在葡萄毬菌和腸毬菌中均未髮現對萬古黴素和替攷拉寧的耐藥菌株。結論：本院血培養暘性結果中條件緻病菌所佔比例及其耐藥性較高，臨床醫生應及時瞭解血培養暘性病原菌的分佈特徵及耐藥情況，閤理使用抗生素，減少醫院內感染及血流感染敗血癥的死亡率。
목적：료해아원2006～2008년혈배양양성표본적병원균분포화내약성변천。방법：채용BacT/Alert3D혈배양의급Vitek-2감정의，대주원환자적혈배양표본진행병원균배양감정시험。세균약물민감성시험채용지편확산법(K-B법)；선용WHONET5.4연건진행통계분석。결과：2006～2008년공분리출병원균298주，기중혁란음성균소점비례분별위64.1%、52.1%화54.8%；혁란양성균소점비례분별위36%、47.9%화46%。혈배양양성검출솔주요분포우혈액과27.1%、중심감호실13.4%、인과9.4%、비뇨외과6.1%화호흡내과5%。세균검출솔교고적혁란음성균주요이대장애희균、동록가단포균、폐염극뢰백균위주；대장애희균화폐염극뢰백균산초엄보β-내선알매( ESBLs)류행솔분별위44.9%(22/49)화26.3%(5/19)，혁란음성균대탄청매희류항균약물잉보지교고적민감성。검출솔교고적혁란양성균주요이금황색포도구균、표피포도구균화인포도구균。재포도구균화장구균중균미발현대만고매소화체고랍저적내약균주。결론：본원혈배양양성결과중조건치병균소점비례급기내약성교고，림상의생응급시료해혈배양양성병원균적분포특정급내약정황，합리사용항생소，감소의원내감염급혈류감염패혈증적사망솔。
Objective:To investigate the distribution and antimicrobial resistance change of positive isolates of blood culture in the from the year 2006 to 2008. Methods:All blood samples were cultured by BacT/Alert 3D,and susceptibility of fungus was tested by Rosco K-B method.Whnet 5.4 was used for statistical analysis.Results:The total number of positive strains of blood culture in the year 2006 to 2008 was 298,and the percentages of gram-negative bacteria was 64.1%,52.1%and 54.8%,compared to the gram-positive was 36%,47.9%and 46%.The most blood culture isolates were isolates from the department of hematology(27.1%),ICU(13.4%),pediatrics(9.4%), urology (6.1%) and the department of respiratory medicine(5%).The gram-negetive bacteria with high detection rate included Escherichia coli,Pseudomonas aeruginosa,Klebsiella peumoniae.The percentages of ESBLs-producing E.coli and ESBLs-producing K pneurnoniae were 44.9%(22/49) and 26.3%(5/19),the gram-negetive bateria was highly susceptible to carbapenem.The gram-positive bateria with high detection rate included Staphylococcus aureus, S.epidermidis and S.hominis.No strains resistant to vancomycin and teicoplanin were found in staphylococcus and Enterococcus isolates. Conclusions:There are many kinds of pathogens in positive blood culture,and they are resistant to a variety of antimicrobial agenta,which should be called attention.
