CAJ | 학술논문

目的：了解血培养标本病原菌分布及其耐药性，为临床合理使用抗生素提供实验室依据。方法回顾性分析长安医院2012年～2014年血培养标本中主要病原菌分布、变迁及耐药情况。结果2012～2014年送检血培养4792例，检出病原菌512株，其中革兰氏阴性菌62.50％（320／512），以大肠埃希菌25.20％（129／512）、肺炎克雷伯菌14.26％（73／512）、铜绿假单胞菌8.20％（42／512）为主；革兰氏阳性菌29.30％（150／512），以金黄色葡萄球菌11.52％（59／512）、凝固酶阴性葡萄球菌10.16％（52／512）为主；真菌7.62％（39／512）。药敏结果显示：大肠埃希菌、肺炎克雷伯菌对碳青霉烯类药物敏感性较高，对其他多种抗菌药均有不同程度耐药；革兰氏阳性球菌对青霉素、红霉素、克林霉素普遍耐药，未发现耐万古霉素、利奈唑胺的菌株。结论血培养病原菌种类分布广，耐药形势严峻，及时准确检测病原菌分布及耐药情况，为临床合理使用抗菌药物提供依据。
목적：료해혈배양표본병원균분포급기내약성，위림상합리사용항생소제공실험실의거。방법회고성분석장안의원2012년～2014년혈배양표본중주요병원균분포、변천급내약정황。결과2012～2014년송검혈배양4792례，검출병원균512주，기중혁란씨음성균62.50％（320／512），이대장애희균25.20％（129／512）、폐염극뢰백균14.26％（73／512）、동록가단포균8.20％（42／512）위주；혁란씨양성균29.30％（150／512），이금황색포도구균11.52％（59／512）、응고매음성포도구균10.16％（52／512）위주；진균7.62％（39／512）。약민결과현시：대장애희균、폐염극뢰백균대탄청매희류약물민감성교고，대기타다충항균약균유불동정도내약；혁란씨양성구균대청매소、홍매소、극림매소보편내약，미발현내만고매소、리내서알적균주。결론혈배양병원균충류분포엄，내약형세엄준，급시준학검측병원균분포급내약정황，위림상합리사용항균약물제공의거。
Objective To understand the distribution and drug resistance of pathogens isolated from blood culture samples Chang’an Hospital from 2012 to 2014 to provide basis for rational use of antibacterial drugs.Methods The clinical date of distribution,changes and drug resistance of main pathogens in blood culture samples during 2012 and 2014 in chang anhospi-tal were retrospectively analyzed.Results 512 pathogenic bacterial strains were isolated from 4 792 blood culture samples in 2012~2014.Among them,gram-negative bacteria accounted for 62.50% (320/512),Escherichia coli ,Klebsiella pneumoni-ae and Pseudomonas aeruginosa accounted for 25.20% (129/512),14.26% (73/512)and 8.20% (42/512)respectively;Gram-positive bacteria accounted for 29.30% (150/512),Staphylococcus aureus and Coagulase-negative Staphylococcus ac-counted for 11.52% (59/512)and 10.16% (52/512)respectively.The rate of fungi was 7.62% (39/512).Susceptibility re-sults showed that Escherichia coli and Klebsiella pneumoniae had highly sensitive to carbapenems,but had a varying degrees of resistance to other antibacterial drugs.The rate of drug resistant of Gram-positive cocci to Penicillin,Erythromycin and Clindamycin had been a high level,but no strains being resistant to van comycin and linezolid had been detected.Conclusion The pathogens causing bloodstream infection widely distribute,and have highly drug-resistant.It is necessary to under-stand the distribution of pathogens isolated from blood culture as well as the changes of drug resistance in a timely manner so as to guide the reasonable clinical medication.