湘潭地区血培养中细菌的分布及耐药性分析

摘要

目的 了解湘潭地区血培养中检出的病原菌分布以及耐药情况,为临床医生合理有效的使用抗菌药提供依据.方法 应用WHONTE5.6分析系统,对湘潭市中心医院、湘潭市一医院、湘潭市二医院2011年10月至2012年9月11 190例血培养分离的病原菌分布以及耐药情况作回顾性分析.结果 送检的11 190例血培养标本中,检出病原菌1184株,阳性率10.6％.其中革兰阳性菌占55.1％,革兰阴性菌占43.5％,真菌占1.4％.感染率占前三位的依次是葡萄球菌属、大肠埃希菌属、肺炎克雷伯菌属.病原菌在各科室的分布占前3位的依次为儿科及新生儿室、重症监护室、内分泌科.革兰阳性菌中葡萄球菌属对青霉素G、红霉素的耐药率高,未发现对万古霉素和利奈唑胺耐药率的菌株.革兰阴性菌中大肠埃希菌属对头孢类抗菌药物的耐药率大于40％,对氟喹诺酮类药物的耐药率大于30％.克雷伯菌属对头孢菌素类药物的耐药率为18.2％.不动杆菌属对头孢菌素类药物的耐药率大于40％.结论 该地区血液感染的患者较多,葡萄球菌属和肠杆菌属是血培养的主要致病菌,耐药情况严重.临床医师应根据病原菌的变化及耐药性,合理应用抗菌药物.%Objective To research the distribution and drug resistance of bacteria in blood culture in Xiangtan city,and provide rational and effective opinions of using antibiotic for clinic doctors.Methods WHONTE5.6 analytic system was used to do retrospective analysis for the 11 190 cases pathogenic bacteria which collected from Oct.2011 to Sept.2012 in Xiangtan Centre Hospital,the First Hospital of Xiangtan and the Second Hospital of Xiangtan,in order to recognize the distribution and drug resistance of bacteria.Results From the 11 190 cases blood samples,we detected 1 184 cases pathogenic bacteria,and the positive rate was 10.6 ％,among which the Gram positive bacteria took up 55.1 ％,the Gram negtive bacteria took up 43.5 ％ and the fungus 1.4 ％.The bacteria with top three infection rate were Staphylococcus,Escherichia coli and Klebsiella pneumoniae.The distribution of bacteria in hospital was paediatrics,ICU and endocrinology department.In Gram positive bacteria,Staphylococcus had high drug resistance rate for penicillin G and erythromycin,but we didn't find any bacteria which had drug resistance for vancomycin and linezolid.In Gram negtive bacteria,drug resistance rate of Escherichia coli for cephalosporin was more than 40％,and for Fluoroquinolones was more than 30％.The drug resistance rate of Klebsiella pneumonia for cephalosporins was 18.2％.The drug resistance rate of Acinetobacter for cephalosporins was more than 40％.Conclusion In local area,we found a little more sufferer who had blood infection,the Staphylococcus and the Enterobacter were the main pathogenic bacteria,and the drug resistance was serious.The clinic doctors should pay attention to the variation of pathogenic bacteria and drug resistance,and use antibacterials rationally.