Objective Analysis on cause of gram positive coccus blood culture positive specimens for bacteria identification and drug sensitivity. Method Methods the bacteria identification and drug sensitivity of positive samples in our hospital from 2012 to March by -2013 in March between the gram positive cocci in blood culture were summarized statistics,with the direct method on the identification and drug sensitivity and conventional drug identification, comparison of two methods of identification, drug sensitivity, which tel the time coincidence rate. Result Identification of the direct method and the conventional method, the coincidence rates of the two methods were 100%, 93.33%, drug sensitive rate were 98.33%, 96.67%, report time were 3-4d, 5-6d, identification accuracy two group with significant difference, drug sensitive coincidence rate, report time difference not significant. Conclusion Identification of gram positive cocci gram negative bacil us compared identification difficult, complex procedures, the identification accuracy is also affected, the use of automated blood culture system identification and drug sensitivity is more reliable, convenient, but the cost is high, the need to buy identification instrument, it was difficult for the grass-roots hospital.%目的：分析讨论革兰氏阳性球菌引起的血培养阳性标本直接细菌鉴定和药敏的方法。方法对我院2012年3月-2013年3月间的革兰氏阳性球菌引起的血培养阳性标本的细菌鉴定和药敏的方法进行归纳统计，用直接法上机鉴定药敏和常规法鉴定药敏，比较两种方法的鉴定、药敏符合率、发报告时间等。结果直接法和常规法两种方法的鉴定符合率分别100%、93.33%，药敏符合率分别为98.33%、96.67%，发报告时间分别为3-4d、5-6d，鉴定符合率两组相比较具有显著性差异，药敏符合率、发报告时间无显著性差异。结论革兰氏阳性球菌的鉴定相比较革兰氏阴性杆菌等的鉴定有些难度，程序复杂，鉴定的准确率也受到影响，使用全自动血培养仪鉴定药敏更为可靠、方便，但成本高，需要购买鉴定仪，这对于基层医院还是有难度。
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