摘要
目的了解该院血培养病原菌临床分布及耐药性分析,指导临床医生合理使用抗菌药物。方法回顾分析2012-2016年该院门诊及住院患者送检的血培养标本,BACTEC-9120全自动血培养仪培养,VITEK-2及Walk Away40plus进行鉴定及药敏分析,参照CLSI当年标准WHONET 5.6软件进行耐药性分析。结果 5年来血流感染共检出859例病原菌,其中革兰阴性菌618株,占71.9%,革兰阳性菌241株,占28.1%。革兰阴性杆菌对亚胺培南、厄他培南、阿米卡星、妥布霉素耐药率较低,存在对亚胺培南、厄他培南耐药的大肠埃希菌和肺炎克雷伯菌。鲍曼不动杆菌对除头孢曲松外的头孢菌素类、氨基糖苷类、β-内酰胺类抗菌药物耐药率均大于35%,铜绿假单胞菌对大部分抗菌药物耐药率较低。耐甲氧西林金黄色葡萄球菌(MRSA)对青霉素G、苯唑西林、红霉素耐药率达100%。结论革兰阴性杆菌在该院住院患者血流感染中占主要地位,不同细菌耐药情况各不相同,应合理应用抗菌药物,加强医院感染的控制。
Objective To investigate the distribution and antibiotic resistance of the pathogens isolated from positive blood culture in the hospital,therefore to guide clinical doctors to use the antimicrobial agents reasonably.Methods The blood culture specimens of outpatient and hospitalized patients in the hospital from2012 to 2016 were retrospectively analyzed,the BACTEC-9120 full automatic blood culture apparatus was used for the culture,VITEK-2 and Walk Away40 plus were used for the identification and the drug sensitivity analysis.The drug resistance analysis was carried out according to the standard WHONET 5.6 of CLSI standard.Results A total of 859 isolates were detected.Gram-negative bacteria were 618 strains accounting for 71.9%,Gram-positive bacteria were 241 strains accounting for 28.1%.Gram-negative bacteria showed lower percentage of resistance rate to imipenem,ertapenem,amikacin and tobramycin,and Escherichia coli and Klebsiella pneumoniae resistant to imipenem and eopenem were existed.The average resistant rates of Acinetobacter baumannii to cephalosporins（besides cefatriaxone）,aminoglycoside andβ-lactam antibiotics were higher than35%.Pseudomonas aeruginosa had relatively low resistant rates to most of drugs.The drug resistant rates of methicillin-resistant S.aureus（MRSA）to penicillin G,oxacillin,erythromycin were 100%.Conclusion Gramnegative bacteria is a major part of the bloodstream infection of hospitalized patients in the hospital.The resistance situation is quite different among various pathogens.Antibiotics should be applied reasonably and strengthen the control of hospital infection.
作者
苏珊珊
王勇
张吉生
曾令怡
张晓丽
SU Shanshan;WANG Yong;ZHANG Jisheng;ZENG Lingyi;ZHANG Xiaoli(Department of Clinical Laboratory,First Affiliated Hospital of Jiamusi University,Jamusi,Heilongjiang 154007,China)
出处
《国际检验医学杂志》
CAS
2018年第16期1993-1996,共4页
International Journal of Laboratory Medicine
基金
黑龙江省自然科学基金资助项目(D201224)
黑龙江省大学生创新创业项目(201710222001)
佳木斯大学科研项目(jc2014-009)
关键词
血培养
病原菌
抗菌药物
耐药性
blood culture
pathogen
antimicrobial agent
antibiotic resistanc
