目的 分析血液感染患者的病原菌分布特点及耐药特性,为临床合理使用抗菌药物提供依据.方法 收集临床血培养阳性患者560例,菌株用VITEK 2 compact鉴定到种,药敏试验采用纸片扩散法(K-B法),结果按临床实验室标准化协会(CLSI) 2010年版标准判读,用WHONET 5.6软件进行耐药性分析.结果 560例患者共分离出568株菌,其中革兰阴性菌占68.0％ (386/568),革兰阳性球菌占29.0％ (165/568),真菌占3.0％ (17/568).大肠埃希菌分离率最高为34.9％ (198/568);其次为肺炎克雷伯菌为16.9％ (96/568);葡萄球菌中以凝固酶阴性葡萄球菌检出率最高为15.5％ (88/568)；金黄色葡萄球菌为9.0％ (51/568).大肠埃希菌和肺炎克雷伯菌对碳青霉烯类抗菌药物100％敏感,对其他抗菌药物有不同程度的耐药；未发现对万古霉素耐药葡萄球菌.结论 血液感染菌株以革兰阴性菌为主,大肠埃希菌是主要感染细菌,凝固酶阴性葡萄球菌的感染不容忽视.%Objective To analyze the pathogenic bacteria distribution and drug resistance of blood infection. Methods A total of 560 cases with positive blood culture results were included in the study. Species of the bacteria were identified with VITEK 2 compact. Antimicrobial susceptibility testing was conducted with disk diffusion ( KB method) . Testing results were interpreted using 2010 CLSI Standards for Antimicrobial Susceptibility Testing. Drug resistance was analyzed using WHONET 5. 6 software. Results The isolated 568 strains consisted of Gram - negative bacilli (386/568, 68. 0% ) , Gram - positive bacilli (165/568, 29. 0% ) , and fungi ( 17/568, 3. 0% ) . Escherichia coli had the highest isolation rate of 34. 9% ( 198/568) , followed by Klebsiella pneumoniae 16. 9% (96/568 ) . Coagulase negative staphylococcus had the highest isolation rate of 15. 5% (88/568) among Staphylococcus, followed by Staphylococcus aureus 9.0% (51/568). Escherichia coli and Klebsiella pneumoniae Vere 100% sensitive to carbopenems, while exhibited varied resistance to other drugs. Staphylococcus was 100% sensitive to vancomycin . Conclusion The bacteria causing blood infection are mainly Gram - negative bacilli. Escherichia coli are the major pathogenic bacteria. The infection of Coagulase negative staphylococcus should be treated with caution.
展开▼
