摘要
目的对成人血培养的病原菌分布、报阳时间及耐药性进行分析,以期为临床早期发现和治疗菌血症提供依据。方法收集2016年7月1日~12月31日陕西省人民医院送检的成人(年龄18周岁)血培养3 537套(需氧瓶+厌氧瓶/套)标本,对报阳瓶分离的病原菌菌株进行细菌鉴定和耐药性分析。结果 3 537套成人血培养标本,共检出485株病原菌,阳性率为13.7%。其中需氧瓶和厌氧瓶均报阳203套(占41.9%),仅需氧瓶报阳220瓶(占45.3%),仅厌氧瓶报阳62瓶(占12.8%)。其中革兰阴性菌229株,占47.2%,以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,对亚胺培南均敏感。革兰阳性菌202株,占41.6%,以金黄色葡萄球菌、表皮葡萄球菌为主,对万古霉素均敏感。检出真菌54株,占11.1%。同时对203套需氧瓶和厌氧瓶均报阳的报阳时间进行分析:革兰阴性菌共121株,厌氧瓶报阳时间比需氧瓶报阳时间早的有95株,占78.5%。需氧瓶报阳时间比厌氧瓶报阳时间早的有26株,占21.5%。革兰阳性菌共78株,厌氧瓶报阳时间比需氧瓶报阳时间早的有45株,占57.7%。需氧瓶报阳时间比厌氧瓶报阳时间早的有33株,占42.3%。真菌共4株,各占50%。临床科室分布以重症医学科、急诊外科、呼吸内科为主。结论成人血培养分离出的病原菌以革兰阴性菌为主,病原菌的种类主要以人体的定植菌为主,且厌氧培养分离菌占比较高,不同病原菌的耐药性差异性大,建议临床医生应结合血培养及药敏结果针对性地对患者治疗。
Objective To study the distribution of pathogens,the positive time and drug resistance of pathogenic bacteria by blood culture of adult patients,in order to provide the basis for the early clinical discovery and treatment of bacteremia. Methods 3 537 specimens of adult blood culture were collected from July 2016 to December 2016,then identified the posi-tive bacteria strains,and analysed the antimicrobial susceptibility.Results In 3 537 specimens of adult blood culture,485 positive samples were detected,and the positive rate was 13.7%（485/3 537）.Including 203 cases（41.9%）of both aerobic and anaerobic positive bottles,220 cases（45.3%）of aerobic positive bottles,and 62 cases（12.8%）of anaerobic positive bottles.About pathogens,229 specimens were gram-negative bacteria strains,accounting for 47.2%.The great majority of bacteria was E.Coli,Klebsiella pneumoniae,Pseudomonas aeruginosa,and they all showed sensitivity to imipenem.202 specimens were gram-positive bacteria strains,accounting for 41.7%,mainly on Staphylococcus aureus and Staphylococcus epidermidis,they all showed sensitive to vancomycin.54 strains were Fungi,accounting for 11.1%.For analysis of 203 ca-ses of aerobic and anaerobic both positive bottles,the results showed that：there were 121 cases of gram-negative bacteria strains,95（78.5%）specimens anaerobic jar to positive time earlier than aerobic bottle to positive time,26（21.5%）speci-mens aerobic bottle jar to positive time earlier than anaerobic bottles to positive time.78 cases of gram positive bacteria,an-aerobic jar to earlier than aerobic bottle to positive time had 45 strains,accounting for 57.7%.Aerobic bottle to positive time earlier than anaerobic bottles to positive time had 33 strains,accounting for 42.3%.Fungi,a total of 4 strains,50% each. Positive pathogens were mainly distributed in I,emergency surgery,respiratory medicine department.Conclusion Pathogen-ic bacteria isolated from the adult blood culture was given priority to gram-negative bacteria,pathogenic bacteria species and drug susceptibility difference was obviously.Clinicians should be combined with blood culture and drug susceptibility results of use of antimicrobial drugs to patients.
出处
《现代检验医学杂志》
CAS
2017年第6期102-105,共4页
Journal of Modern Laboratory Medicine
关键词
成人血培养
病原菌
报阳时间
药敏分析
adult blood culture
pathogenic bacteria
the positive time
drug susceptibility analysis
