【摘要】 目的分析我院血培养阳性标本的病原菌分布及耐药情况,为临床医生合理使用抗菌药物提供依据。方法收集本院2013年1月~2015年12月血培养阳性的标本,采用法国梅里埃公司的VITEK-2 Compact仪器进行菌株的鉴定和药敏试验,分析病原菌构成及其耐药性。结果在8 736份血培养标本中,检出病原菌864株,阳性率约为9.89%。其中,革兰阴性菌407株,占47.11%,前3位分别是大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌;革兰阳性菌386株,占44.67%,前3位分别为凝固酶阴性葡萄球菌(CNS)、金黄色葡萄球菌、粪肠球菌属;真菌59株,占6.83%;病原菌主要来自ICU、血液免疫内科、呼吸内科、儿科;产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的检出率分别为45.3%和24.1%;肠杆菌科细菌对碳青霉烯类抗菌药物的敏感率仍保持100.00%;铜绿假单胞菌对阿米卡星、哌啦西林/他唑巴坦、妥布霉素的耐药率分别为9.09%、9.09%、11.36%;MRSA检出率为16.0%;3年来未检出对万古霉素、利奈唑胺耐药的革兰阳性菌。结论宣传和规范抗菌药物的合理应用,同时加强医院感染控制是降低细菌耐药性的重要策略。更多还原

【Abstract】 Objective To analyze the distribution and the drug resistance of the pathogens from blood culture,and to provide basici for the clinicians to rationally use antibiotic. Methods The retrospective analysis was conducted on distribution and drug-resistance profile of the pathogens from blood culture collected from both inpatients and outpatients in our hospital from 2013 to 2015. The identification of strains and the drug susceptibility testing were performed by the VITEK-2 Compacts system. Results The positive incidence of these 8736 samples is 9.89%. There were 407 strains of gram-negative bacilli(47.11%),386 strains of gram-positive bacilli(44.67%)and 59 strains of fungi(6.83%). The top three species of the gram-negative bacilli were escherichia coli,klebsiella pneumonia and pseudomonas aeruginosa. The top three species of the gram-positive bacilli were the coagulase-negative staphylococcui,staphylococcus aureusande,faecalis,the pathogens were mainly from ICU,department of hematology and immunology,respiratory medicine and pediatrics,the detection rates of ESBLs and E.coli were 45.3% and 24.1%,pneumonia and enterobacteriaceae were 100.00% sensitive to carbapenems,resistance rates of pseudomonas aeruginosa to amikacin,piperacillin/tazobactam and tobramycin were 9.09%、9.09% and 11.36%,MRSA were16.0%. No strains of ancomycinresistantdetection or linezolid-resistantdetection strains were found in gram-positive bacilli. Conclusion To promote and standardize the rational use of antibiotics,and to strengthen the control of hospital infection is an important strategy to reduce the drug resistance of the bacteria.更多还原