摘要
目的 探讨血培养报阳时间在临床鉴别感染菌和污染菌中的意义。方法 对医院2015年1月-8月送检12 861份血培养中分离的1 300株阳性菌株的报阳时间、实验室数据及临床资料进行综合分析,并且将1 254株细菌分成感染菌组892株和污染菌组362株。结果 1 300株阳性分离菌中,主要为大肠埃希菌占30.31%,其次是凝固酶阴性葡葡球菌占26.46%;且高于感染菌组,两组比较有统计学差异（P〈0.05）,血培养报阳时间0~12h共检出47.1%、污染占4.1%,其中金黄色葡萄球菌、肺炎链球菌、鲍氏不动杆菌等均为感染菌,占100%;13~24h检出31.7%、污染占42.1%;25~48h检出15.0%、污染占60.6%;〉48h检出6.2%、污染占74.4%。结论 阳性报警时间是鉴别分离菌株是否为污染菌的重要指标之一,临床医师需要结合血培养报阳时间、实验室指标、临床症状等进行综合判断,针对病原菌有效合理的使用抗菌药物,避免抗菌药物滥用。
OBJECTIVE To explore the significance ot postuve alarm bacteria causing infections to bacteria causing contamination. METHODS From Jan 2015 to Aug 2015, the positive alarm time, laboratory data, and clinical data of 1 300 positive bacteria strains that were cultured from 12 861 sub- mitted blood specimens were comprehensively analyzed. Totally 1254 strains of bacteria were divided into the in- fectious bacteria group with 89Z strains and the contaminated bacteria group with 362 strains. RESULTS Of the 1300 strains of positive bacteria, 30.31% were Escherichia coli, and 26.46 % were coagulase-negative Staphylo- coccus; there was significant difference between the infectious bacteria group and the contaminated bacteria group （P〈0. 05）. Totally 4,7.1 % strains of infectious bacteria and 4.1 % of contaminated bacteria were isolated at the positive alarm time of blood couture from 0 to 12 hours; the Staphylococcus aureus, Streptococcus pneumoniae, and Acinetobacter baurnannii were the infectious bacteria, accounting for 100.0 %. Totally 31.7 % strains of infec- tious bacteria and 42.1% of contaminated bacteria were isolated at the positive alarm time of blood couture from 13 to 24 hours. Totally 15.0% strains of infectious bacteria and 60.6 % of contaminated bacteria were isolated at the positive alarm time of blood couture from 25 to 48 hours. Totally 6.2% strains of infectious bacteria and 74. % of contaminated bacteria were isolated at the positive alarm time of blood cultuer more than 48 hours. CONCLUSION The positive alarm time is one of the important indicators to determine whether the clinical isolates are the contaminated bacteria. The clinician should make comprehensive judgment by combining with the positive alarm time of blood culture, laboratory indicators, and clinical symptoms, reasonably use antibiotics aiming at the pathogens, and avoid the abuse of antibiotics.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2016年第21期4885-4887,共3页
Chinese Journal of Nosocomiology
基金
贵州省科技厅资助项目(黔科合LH[2015]7480)
贵州省中医药管理局(QZYY-2015-107)
关键词
血培养
报阳时间
感染菌
污染菌
Blood culture
Positive alarm time
Infectious bacteria
Contaminated bacteria
