514株血培养分离菌株的分布与耐药性分析.docx

514株血培养分离菌株的分布和耐药性分析摘要 目的：分析番禺区中心医院血流感染的主要病原菌的分布和耐药性，指导临床合理使用抗菌药物。方法：对我院2013年1月一2014年6月收集5392份血培养标本培养采用Bact/Alert3D240全自动血培养仪,分离鉴定菌株和药敏试验采用VITEK-2 Compact全自动细菌鉴定药敏仪。结果：5392份血培养标本分离出致病菌514株，革兰阴性菌330株，占64.2％，革兰阳性菌159株，占30.9%，真菌25株，占4.9%。分离率前五位的病原菌分别为大肠埃希氏菌148株，肺炎克雷伯菌60株，金黄色葡萄球菌58株，凝固酶阴性葡萄球菌54株，铜绿假单胞菌25株。革兰阴性菌对阿米卡星、碳青霉烯类药物耐药率低，葡萄球菌未发现对万古霉素、利奈唑胺耐药的菌株。结论：番禺区中心医院血培养分离病原菌以革兰阴性菌为主，呈现为多重耐药性，临床应给予重视。 关键词：血培养；病原菌；细菌耐药性；菌血症Analysis of pathogens distribution and drug resistance in 514 blood culture QIN Jue, QIU Wei-bo(Department of Laboratory Medicine Panyu center hospital，Guangzhou 511400)Abstract：Objectiveto investigate the distribution and drug resistance of major pathogens from blood infections in Panyu center hospital, to guide clinical use of antimicrobial agents. Methods: Pathogens were isolated from 5392blood culture specimens during Jan.2013 to Jun.2014,which were cultured by BacT/Alert 3D240. The identification and drug sensitivity analysis were determined by VITEK-2 system. Results:Totally,514 pathogens were isolated from 5392blood culture specimens, with 330 strains of gram negative bacilli，counted for 64.2％，159 strains of gram positive bacteria, counted for 30.9%，25 strains of fungi counted for 4.9%.The separation rate of the top five pathogenic bacteria were E. coli 148 strains，klebsiella pneumoniae 60 strains，staphylococcus aureus 58 strains，coagulase?negative?staphylococcus54 strains，pseudomonas aeruginosa 25 strains，respectively. Gram negative bacteria to amikacin, penicillium carbon alkene drug resistant rate is low. The Staphylococcus aureusto vancomycin,Linezoliddrug-resistant strains were not found. Conclusion: Gram-negative bacteriawere the main pathogens of the blood infection in Panyu center hospital,appear to multiple drug resistance.Clinical?doctors should pay more attention to it .Key words：Blood culture；Pathogen；Drug resistance; Bacteremia血流感染是临床常见、严重的感染性疾病，具有起病急、病死率高的特点，血流感染是导致临床死亡的重要原因，血培养阳性是确诊血流感染的重要依据。随着抗生素和免疫抑制剂的大量使用以及放疗化疗和介入性治疗的广泛应用，大大增加了患者发生血流