10 941份血培养标本中病原菌群分布及耐药性分析 FREE

Distribution and drug resistance of pathogens isolated from 10 941 blood culture samples FREE

摘要:

目的动态监测和分析某院感染患者血培养标本中的病原菌分布及其耐药性，为临床合理应用抗菌药物提供实验室依据。方法采用BacT/ALERT 3D全自动血培养仪对10 941份血液标本进行检测，药敏试验按照美国临床实验室标准化研究所标准，采用KB纸片法进行；应用WHONET5.4软件分析血培养标本中所分离病原菌的分布和药敏结果。结果10 941份血液标本中，培养阳性673份，阳性率6.15%；共检出病原菌688株，其中肠杆菌科细菌占37.94%(261/688)，非发酵菌30.67%(211/688)，葡萄球菌属10.17%(70/688)，肠球菌属8.58%(59/688)，真菌5.23%(36/688)，污染菌6.54%(45/688)，布氏杆菌0.87%（6/688）。大肠埃希菌对氨苄西林/舒巴坦、头孢曲松、头孢呋辛、头孢他啶及环丙沙星的耐药率分别为48.27%、55.17%、82.76%、53.10%、68.97%；鲍曼不动杆菌对阿米卡星、头孢他啶、哌拉西林/他唑巴坦、环丙沙星的耐药率分别为35.06%、38.96%、32.47%、64.94%；金黄色葡萄球菌对红霉素、克林霉素、左氧氟沙星的耐药率分别为80.77%、46.15%、75.00%；屎肠球菌对青霉素、红霉素、利福平、左氧氟沙星的耐药率分别为94.74%、97.37%、97.36%、89.47%。结论血流感染病原菌种类分布较广，耐药性较强。临床应严格执行血培养标本的采送规范，避免污染和提高送检质量。

Abstract:

ObjectiveTo monitor and analyse the distribution and drug resistance of pathogens isolated from blood culture samples in a hospital , so as to  provide  evidence for the clinical therapy of infections.Methods10 941 blood  samples were detected by BacT/ALERT 3D automated blood culture system , and antimicrobial  susceptibility tests  were performed   with  KirbyBauer disk diffusion method, results were analyzed by WHONET5.4 software.ResultsAmong 10 941 samples, 673 (6.15%) were blood culture positive, 688 pathogens were isolated, 37.94% (261/688) of which were Enterobacteriaceae, 30.67%(211/688) were nonfermentative bacteria, 10.17% (70/688) were Staphylococcus spp.,8.58% (59/688) were Enterococcus spp., 5.23% (36/688) were fungi, 6.54% (45/688) were contaminated bacteria, 0.87%(6/688) were Brucella. The  resistant rate of Escherichia coli to ampicillin/sulbactam, ceftriaxone, cefuroxime, ceftazidime, and ciprofloxacin were 48.27%, 55.17%, 82.76%, 53.10%, and 68.97% respectively; The resistant rate of Acinetobacter baumannii to amikacin, ceftazidime, piperacillin / tazobactam and ciprofloxacin were 35.06%, 38.96%, 32.47%,and 64.94% respectively; The resistant rate of Staphylococcus aureus to erythromycin, clindamycin, levofloxacin were 80.77%, 46.15%, and 75.00% respectively; The resistant rate of Enterococcus feacium to penicillin, erythromycin, rifampicin, and levofloxacin were 94.74%, 97.37%, 97.36%, and 89.47% respectively.ConclusionThe pathogens causing bloodstream infection are widely distributed and highly drug resistant.Detection of clinical specimens of blood culture should conform to the standard in order to avoid contamination and enhance detection quality  .