海南医学
海南醫學
해남의학
HAINAN MEDICAL JOURNAL
2014年
21期
3180-3182,3183
,共4页
血液培养%病原体%抗药性%抗菌药物%合理用药
血液培養%病原體%抗藥性%抗菌藥物%閤理用藥
혈액배양%병원체%항약성%항균약물%합리용약
Blood culture%Pathogens%Drug resistance%Antimicrobial agents%Rational use of drug
目的：了解临床血培养致病菌的菌种分布及其耐药情况，为临床合理应用抗菌药物提供科学的依据。方法血液培养标本用全自动血液培养仪BACTEC-FX BD进行培养，阳性标本用全自动微生物鉴定/药敏仪Phoenix-100 BD进行鉴定，并对标本中分离出来的病原菌的分布及耐药情况进行回顾性分析。结果在4308份血液标本中分离出病原菌385株，阳性检出率为8.9%。其中革兰氏阳性菌218株，占56.6%；革兰氏阴性菌140株，占36.4%；真菌27株，占7.0%。分离率占前6位者为大肠埃希氏菌72株，占18.7%、表皮葡萄球菌44株，占11.4%、真菌27株，占7.0%、金黄色葡萄菌26株，占6.8%、肺炎克雷伯菌24株，占6.2%、腐生葡萄球菌20株，占5.2%。大肠埃希氏菌的耐药率以亚胺培南、美罗培南最低（0），表皮葡萄球菌的耐药率以利奈唑胺、呋喃妥因最低(0)，金黄色葡萄的耐药率以呋喃妥因、利奈唑胺最低(0)。结论血液培养主要病原菌为革兰氏阳性球菌，各种条件致病菌呈上升趋势，多数病原菌为多重耐药且比较严重，临床应针对性抗菌治疗，并积极预防和控制院内交叉感染，加强血培养标本采集的规范。
目的：瞭解臨床血培養緻病菌的菌種分佈及其耐藥情況，為臨床閤理應用抗菌藥物提供科學的依據。方法血液培養標本用全自動血液培養儀BACTEC-FX BD進行培養，暘性標本用全自動微生物鑒定/藥敏儀Phoenix-100 BD進行鑒定，併對標本中分離齣來的病原菌的分佈及耐藥情況進行迴顧性分析。結果在4308份血液標本中分離齣病原菌385株，暘性檢齣率為8.9%。其中革蘭氏暘性菌218株，佔56.6%；革蘭氏陰性菌140株，佔36.4%；真菌27株，佔7.0%。分離率佔前6位者為大腸埃希氏菌72株，佔18.7%、錶皮葡萄毬菌44株，佔11.4%、真菌27株，佔7.0%、金黃色葡萄菌26株，佔6.8%、肺炎剋雷伯菌24株，佔6.2%、腐生葡萄毬菌20株，佔5.2%。大腸埃希氏菌的耐藥率以亞胺培南、美囉培南最低（0），錶皮葡萄毬菌的耐藥率以利奈唑胺、呋喃妥因最低(0)，金黃色葡萄的耐藥率以呋喃妥因、利奈唑胺最低(0)。結論血液培養主要病原菌為革蘭氏暘性毬菌，各種條件緻病菌呈上升趨勢，多數病原菌為多重耐藥且比較嚴重，臨床應針對性抗菌治療，併積極預防和控製院內交扠感染，加彊血培養標本採集的規範。
목적：료해림상혈배양치병균적균충분포급기내약정황，위림상합리응용항균약물제공과학적의거。방법혈액배양표본용전자동혈액배양의BACTEC-FX BD진행배양，양성표본용전자동미생물감정/약민의Phoenix-100 BD진행감정，병대표본중분리출래적병원균적분포급내약정황진행회고성분석。결과재4308빈혈액표본중분리출병원균385주，양성검출솔위8.9%。기중혁란씨양성균218주，점56.6%；혁란씨음성균140주，점36.4%；진균27주，점7.0%。분리솔점전6위자위대장애희씨균72주，점18.7%、표피포도구균44주，점11.4%、진균27주，점7.0%、금황색포도균26주，점6.8%、폐염극뢰백균24주，점6.2%、부생포도구균20주，점5.2%。대장애희씨균적내약솔이아알배남、미라배남최저（0），표피포도구균적내약솔이리내서알、부남타인최저(0)，금황색포도적내약솔이부남타인、리내서알최저(0)。결론혈액배양주요병원균위혁란씨양성구균，각충조건치병균정상승추세，다수병원균위다중내약차비교엄중，림상응침대성항균치료，병적겁예방화공제원내교차감염，가강혈배양표본채집적규범。
Objective To study the distribution of common pathogens and drug resistance to common antibiot-ics in patients with septicemia, and to provide scientific basis for clinically targeted antimicrobial therapy. Methods By using BACTEC-FX BD automatic blood culture system for culturing blood samples, the pathogens identification and resistance test were carried out by automatic microorganism identification instrument (Phoenix-100 BD), and the dis-tribution and drug resistance of pathogens were studied and analyzed. Results Totally 385 strains of pathogens were isolated from 4 308 blood culture samples, with the positive rate of 8.9%, among which 218 (56.6%) were Gram-posi-tive bacteria, 140 (36.4%) were Gram-negative bacteria, and 27 (7.0%) were fungi. The top six pathogens with isola-tion rate higher than others were Escherichia coli (72 strains, 18.7%), Staphylococcus epidermidis (44 strains, 11.4%), Fungi (27 strains, 7.0%), Staphylococcus auresu (26 strains, 6.8%), Klebsiella pseudomonas (24 strains, 6.2%), Staphy-lococcus saprophyticus (20 strains, 5.2%). Escherichia coli was found lowest resistant to Imipenem and Meropenem, while Staphylococcus epidermidis and Staphylococcus auresu was lowest resistant to Linezolid and Nitrofurantoin. Conclusion The main pathogens of septicemia are Gram-positive bacteria, with various conditional pathogenic bac-teria on the rise. The majority of pathogens are multi-drug resistant to antibiotics. Clinical physicians should have per-sistence to actively prevent and control nosocomial cross-infections.
