摘要
目的研究老年病房患者4年血培养常见病原菌分布及耐药情况,为临床治疗血流感染提供依据。方法对我院老年病房2008年1月-2011年12月送检血培养阳性患者资料进行回顾性分析。血培养及检测采用BacT/ALERT3D自动化血培养仪,病原菌鉴定及药敏试验采用VITEK-2全自动细菌分析仪进行。结果 3 310份血培养标本中分离出病原菌473株,阳性率为14.29%;其中革兰阳性菌占62.16%,革兰阴性菌占27.27%,真菌占10.57%;凝固酶阴性葡萄球菌占分离菌首位,其次为肠球菌、大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌、鲍曼不动杆菌等;碳青霉烯类对大肠埃希菌和肺炎克雷伯菌抗菌能力较强,而对铜绿假单胞菌抗菌能力明显降低;革兰阳性球菌对利奈唑胺和氨基糖苷类抗菌药物高度敏感;真菌对常用抗真菌药物敏感性较好。结论本院老年病房中血液标本中的病原菌以革兰阳性菌为主,耐药率较高。了解病原菌的分布及耐药情况,可为临床合理应用抗生素提供参考。
Objective To provide the evidence for clinical treatment of bacteremia by studying the distribution and drug resistance of blood cultured pathogens in elderly patients. Methods Clinical data about elderly patients with positive blood samples admitted to our hospital from January 2008 to December 2011 were retrospectively analyzed. Blood samples were cultured and tested with the BacT/ALERT3D automatic blood culture system. Pathogens were identified and their drug sensitivity was tested with the VITEK-2 automatic analyzer. Results Four hundred and seventy-three strains were isolated from 3 310 blood samples with a positive rate of 14.29%. Of the 473 strains, gram-positive bacteria, gram-negative bacteria and fungi accounted for 62.16%, 27.27% and 10.57%, respectively. The number of isolated coagulase-negative Staphylococci was the greatest, followed by that of Enterococci, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa and Acinetobacter baumannii pneumoniae. Of these bacteria, Escherichia coli and Klebsiella pneumoniae had a stronger resistance while P. aeruginosae had a weaker resistance to carbapenems. Gram-positive Staphylococci and fungi were most sensitive to linezolid and aminoglycosides while fungi were sensitive to common antifungal agents. Conclusion Gram-positive bacteria are the main pathogens isolated from blood samples taken from elderly patients and have a high drug resistance. Understanding of their distribution and drug resistance can provide reference for rational use of antibiotics in clinical treatment of bacteremia.
出处
《军医进修学院学报》
CAS
2012年第12期1259-1261,共3页
Academic Journal of Pla Postgraduate Medical School
基金
军队"十二五"保健专项(11BJZ01)
关键词
老年人
细菌感染和真菌病
病原菌
耐药性
aged
bacterial infections and mycoses
pathogen
drug resistance
