【摘要】 目的监测和分析我院最近两年来感染患者中血培养的病原菌分布情况和耐药特点,为临床抗感染治疗提供最新依据。方法采用VITEK系统鉴定细菌,Kirby-Bauer琼脂扩散法作体外药敏试验,应用WHONET5.3软件分析血培养标本所分离的病原菌的分布情况和药敏结果。结果4603例血培养共检出587株病原菌,其中革兰阴性菌383株(占65.25%),革兰阳性菌180株(占30.66%),真菌24株(占4.09%)。亚胺培南与美罗培南对大肠埃希菌和肺炎克雷伯菌作用效果较好,但对鲍曼不动杆菌耐药较严重,耐药率达35%以上。产ESBLs的大肠埃希菌和肺炎克雷伯菌的检出率为61.24%和48.91%。糖肽类和利奈唑胺抗菌药物对革兰阳性球菌高度敏感。葡萄球菌中MRSA和MRCNS的检出率分别为75.47%和66.67%。结论目前我院血培养分离的病原菌种类分布较广,耐药性差异较大,对血培养分离株进行早期监测和耐药性分析非常必要,可为临床医生合理应用抗菌药物提供重要依据,防止抗生素滥用及新耐药菌株的产生。更多还原

【Abstract】 Objective A surveillance and analysis were performed to investigate the characteristics of distribution and antimicrobial resistance of microorganisms isolated from blood cultures in the past two years in our hospital and to provide new evidence for the clinical therapy of infections.Methods Microorganisms were identified by VITEK System and K-B mothod was used for the antibiotics susceptibility test.Results were analyzed based on WHONET5.3 software.Results Five hundred eighty seven microorganisms were isolated from 4,603 samples,of which Gram-negative bacteria were 383(65.25%),Gram-positive bacteria were 180(30.66%) and fungi were 24(4.09%).E.coli and Klebsiella pneumoniae were sensitive to imipenem and meropenem,but Acinetobacter baumannii were resistant to them,whose resistance rate was above 35%.The positive rates of ESBL-producing strains of E.coli and Klebsiella pneumoniae were 61.24% and 48.91% respectively.Gram-positive cocci were highly sensitive to the antimicrobial agents of glycopeptide and linezolid.The detection rates of MRSA and MRCNS were 75.47% and 66.67%.Conclusions The microorganisms isolated from blood culture were widely distributed and resistant to antibiotics were quite different.It′s necessary to monitor and analyze the strains isolated from blood culture and their resistance,which will help clinicians prescribe antibacterial drugs reasonably to prevent the abuse of antibiotics and the emergence of new drug-resistant strains.更多还原