【摘要】 目的研究2011—2013年安徽医科大学解放军174临床学院血培养阳性标本的病原菌分布和耐药性变迁情况,为临床合理使用抗菌药物提供依据。方法收集血培养阳性菌株,细菌鉴定和药敏分析用微生物鉴定药敏测试系统96和梅里埃VITEK 2 Compact全自动细菌鉴定及药敏分析仪,按照美国临床实验室标准化组织(CLSI)2013标准判读结果。结果自6 687份血培养标本中共检出病原菌765株,阳性率为11.4%。其中,革兰阴性菌占54.2%,革兰阳性菌占42.6%,真菌占3.1%。病原菌主要为大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌、铜绿假单胞菌。药敏检测:万古霉素和利奈唑胺抗菌对革兰阳性菌抗菌活力最好,未发现耐药菌株;碳青霉烯类对大肠埃希菌和肺炎克雷伯菌抗菌活力最好,但鲍曼不动杆菌对其耐药率较高,多黏菌素B抗菌活力最好。结论该院患者血流感染的病原菌以革兰阴性菌较多,耐药现象严重。因此,应加强监测的分析,以指导临床合理用药物。更多还原

【Abstract】 [Objective]To study the pathogen distribution and drug resistance changes of positive samples for blood culture in Chinese People’s Liberation Army No.174 Clinical College of Anhui Medical University from 2011-2013,provide the basis for rational use of antimicrobial agents in clinic.[Methods]The positive strains from blood culture were collected.Bacterial identification and drug susceptibility analysis were performed by Microscan Walk Away 96 and VITEK 2 Compact.The results were interpreted according to CLSI 2013.[Results]Totally 765 strains of pathogens were isolated from 6 687 blood culture samples,with the positive rate of 11.4%,and gram-negative bacteria,gram-positive bacteria and fungi accounted for 54.2%,42.6%and 3.1%,respectively.The pathogens mainly included Escherichia coli,coagulase negative Staphylococcus,Klebsiella pneumoniae,Staphylococcus aureus and Pseudomonas aeruginosa.The drug susceptibility analysis showed that vancomycin and linezolid performed the best antibacterial activity to gram-positive bacteria,and no resistant strains were found.Carbapenems showed the best antibacterial activity on Escherichia coli and Klebsiella pneumoniae,but Acinetobacter baumannii isolates were highly resistant to it,while polymyxin B showed the lowest resistance to the bacteria.[Conclusion]Gram-negative bacteria were the major pathogens of blood-borne infections in this hospital,and the drug resistance to common drug is very serious.Therefore,it is necessary to strengthen the monitoring and analysis to guide clinical rational use of antibacterial drugs.更多还原