国际检验医学杂志
國際檢驗醫學雜誌
국제검험의학잡지
INTERNATIONAL JOURNAL OF LABORATORY MEDICINE
2015年
3期
303-305
,共3页
杨丽静%银吉卓玛%巫全桂
楊麗靜%銀吉卓瑪%巫全桂
양려정%은길탁마%무전계
血培养%细菌%真菌%耐药性%药敏试验
血培養%細菌%真菌%耐藥性%藥敏試驗
혈배양%세균%진균%내약성%약민시험
blood culture%bacteria%fungus%drug resistance%drug sensitivity test
目的：调查2010～2013年医院常见真菌、细菌的耐药性，为临床用药提供依据。方法用 BacT／Alert 3D 全自动血培养仪进行培养，用 VITEK 鉴定系统进行细菌鉴定和药敏试验，用 WHONET5．4统计结果。结果1176例送检标本中阳性标本108例，阳性率为9．18％。分离病原菌123株，革兰阳性菌60株（48．78％），革兰阴性菌为47株（38．21％），真菌为16株（13．01％）。前5位病原菌依次为凝固酶阴性葡萄球菌（44株）、大肠埃希菌（18株）、肺炎克雷伯菌（15株）、白色念珠菌（10株）、金黄色葡萄球菌（7株）。耐甲氧西林凝固酶阴性葡萄球菌（MRCNS）、金黄色葡萄球菌（MRSA）检出率分别为72．73％（32／44）、57．14％（4／7），MRSA 和 MRCNS 较 MSSA 和 MSCNS 对抗菌药物耐药率高，未发现对万古霉素及利奈唑胺耐药的葡萄球菌。酮康唑、氟康唑、咪康唑对白色念珠菌敏感率高。大肠埃希菌和肺炎克雷伯菌产超广谱β-内酰胺酶（ESBLs）率分别为50．00％、40．00％，亚胺培南和美罗培南敏感率为100．00％。头孢哌酮／舒巴坦、哌拉西林／三唑巴坦对肠杆菌科细菌、铜绿假单胞菌敏感率较高。结论血培养以凝固酶阴性葡萄球菌为主，分离菌的耐药性较强，应加强血培养，指导临床合理用药。
目的：調查2010～2013年醫院常見真菌、細菌的耐藥性，為臨床用藥提供依據。方法用 BacT／Alert 3D 全自動血培養儀進行培養，用 VITEK 鑒定繫統進行細菌鑒定和藥敏試驗，用 WHONET5．4統計結果。結果1176例送檢標本中暘性標本108例，暘性率為9．18％。分離病原菌123株，革蘭暘性菌60株（48．78％），革蘭陰性菌為47株（38．21％），真菌為16株（13．01％）。前5位病原菌依次為凝固酶陰性葡萄毬菌（44株）、大腸埃希菌（18株）、肺炎剋雷伯菌（15株）、白色唸珠菌（10株）、金黃色葡萄毬菌（7株）。耐甲氧西林凝固酶陰性葡萄毬菌（MRCNS）、金黃色葡萄毬菌（MRSA）檢齣率分彆為72．73％（32／44）、57．14％（4／7），MRSA 和 MRCNS 較 MSSA 和 MSCNS 對抗菌藥物耐藥率高，未髮現對萬古黴素及利奈唑胺耐藥的葡萄毬菌。酮康唑、氟康唑、咪康唑對白色唸珠菌敏感率高。大腸埃希菌和肺炎剋雷伯菌產超廣譜β-內酰胺酶（ESBLs）率分彆為50．00％、40．00％，亞胺培南和美囉培南敏感率為100．00％。頭孢哌酮／舒巴坦、哌拉西林／三唑巴坦對腸桿菌科細菌、銅綠假單胞菌敏感率較高。結論血培養以凝固酶陰性葡萄毬菌為主，分離菌的耐藥性較彊，應加彊血培養，指導臨床閤理用藥。
목적：조사2010～2013년의원상견진균、세균적내약성，위림상용약제공의거。방법용 BacT／Alert 3D 전자동혈배양의진행배양，용 VITEK 감정계통진행세균감정화약민시험，용 WHONET5．4통계결과。결과1176례송검표본중양성표본108례，양성솔위9．18％。분리병원균123주，혁란양성균60주（48．78％），혁란음성균위47주（38．21％），진균위16주（13．01％）。전5위병원균의차위응고매음성포도구균（44주）、대장애희균（18주）、폐염극뢰백균（15주）、백색념주균（10주）、금황색포도구균（7주）。내갑양서림응고매음성포도구균（MRCNS）、금황색포도구균（MRSA）검출솔분별위72．73％（32／44）、57．14％（4／7），MRSA 화 MRCNS 교 MSSA 화 MSCNS 대항균약물내약솔고，미발현대만고매소급리내서알내약적포도구균。동강서、불강서、미강서대백색념주균민감솔고。대장애희균화폐염극뢰백균산초엄보β-내선알매（ESBLs）솔분별위50．00％、40．00％，아알배남화미라배남민감솔위100．00％。두포고동／서파탄、고랍서림／삼서파탄대장간균과세균、동록가단포균민감솔교고。결론혈배양이응고매음성포도구균위주，분리균적내약성교강，응가강혈배양，지도림상합리용약。
Objective To investigate the drug resistance of fungi and bacteria detected by using blood culture from 2010 to 2013. Methods BacT/Alert 3D blood culture system was used,Then VITEK microbiological analyzer was used to identify the bacteria and perform drug sensitivity test,the results were analyzed using WHONET5.4 software.Results There were 108 positive speci-mens among 1 176 samples,the detection rate was 9.18%.Among 123 isolates,60 strains were gram positive(48.78%),47 strains were gram negative(38.21%),16 strains was fungus(13.01%).The major five kinds of pathogenic bacteria were coagulase nega-tive staphylococcus(CNS,44 strains),Escherichia coli (18 strains),Klebsiella pneumoniae (15 strains),candida albicans (10 strains)and Staphylococcus aureus(7 strains).The detection rate of methicillin resistant coagulase negative staphylococci(MRCNS) and Staphylococcus aureus(MRSA)were 72.73%(32/44)in CNS strains and 57.14% (4/7)in Staphylococcus aureus strains,the antibiotic resistance rates of MRSA and MRCNS were significantly higher than that of MSSA and MSCNS,none of Staphylococcus aureus strain was resistant to vancomycin and linezolid.The sensitive rate of Candida albicans to fluconazole,ketoconazole and mi-conazole was high.50% of Escherichia coli strains and 40% percent of Klebsiella pneumoniae strains produced extended spectrum beta-lactamases(ESBLs).The sensitive rate of Enterobacteriaceae to imipenem and meropenem were both 100.00%.The sensitive rate of Pseudomonas aeruginosa to cefoperazone/shubatan,piperacillin/tazobactam were both high.Conclusion CNS is the major kind of bacteria in blood culture.The antibiotic resistance of bacteria is increasing and it is necessary to pay attention to blood cul-ture results in order to guide the clinical use of drugs.
