【摘要】：目的分析四川省中醫(yī)院血培養(yǎng)陽(yáng)性病原菌分布及耐藥性特點(diǎn),為臨床診斷和制定治療方案提供依據(jù)。方法對(duì)本院2014-2015年住院病人共6 271份血標(biāo)本采用ac T/Alert3D 60/120全自動(dòng)血培養(yǎng)儀進(jìn)行培養(yǎng),陽(yáng)性者用VITEK-2 Compact細(xì)菌分析鑒定和藥敏試驗(yàn)系統(tǒng)進(jìn)行細(xì)菌鑒定及藥敏實(shí)驗(yàn)。結(jié)果 2014年和2015年送檢血標(biāo)本分別為2 808份和3 463份,病原菌檢出率分別為10.90%和9.88%;革蘭陰性菌所占比例分別為61.43%和56.30%,前3位均為大腸埃希菌、肺炎克雷伯菌和鮑曼不動(dòng)桿菌。大腸埃希菌對(duì)氨芐西林的耐藥率持續(xù)偏高(≥86.0%);肺炎克雷伯菌對(duì)阿莫西林/克拉維酸及喹諾酮類(lèi)的耐藥率分別從37.50%、18.75%上升至81.25%、50.00%;鮑曼不動(dòng)桿菌對(duì)頭孢曲松和氨曲南的耐藥率達(dá)100.00%。革蘭陽(yáng)性菌中,以凝固酶陰性葡萄球菌、金黃色葡萄球菌和屎腸球菌為主;表皮葡萄球菌對(duì)青霉素和苯唑西林的耐藥率達(dá)100.00%;金黃色葡萄球菌中,MARSA檢出率從22.22%上升到34.78%;表皮葡萄球菌和金黃色葡萄球菌均無(wú)呋喃妥因、替加環(huán)素、萬(wàn)古霉素和利奈唑胺耐藥菌株。結(jié)論血流感染病原菌主要為革蘭陰性細(xì)菌;病原菌對(duì)常用抗菌藥物均有不同程度的耐藥,臨床應(yīng)加強(qiáng)細(xì)菌耐藥性監(jiān)測(cè),臨床醫(yī)師應(yīng)根據(jù)不同細(xì)菌合理選擇抗菌藥物并嚴(yán)格遵守抗菌素使用指南。
[Abstract]:Objective To analyze the distribution and drug resistance of blood culture positive pathogens in Sichuan Hospital of Traditional Chinese Medicine, and to provide evidence for clinical diagnosis and treatment. Methods A total of 6 271 blood samples were cultured by AC T/Alert 3D 60/120 automatic blood culture instrument from 2014 to 2015. The positive patients were identified by VITEK-2 Compact bacteria analysis and drug use. Results In 2014 and 2015, 2 808 blood samples and 3 463 blood samples were collected. The detection rates of pathogenic bacteria were 10.90% and 9.88% respectively. Gram-negative bacteria accounted for 61.43% and 56.30% respectively. The first three were Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii. Ampicillin resistance rate continued to be high (> 86.0%); Amoxicillin/clavulanate and quinolones resistance rate of Klebsiella pneumoniae increased from 37.50%, 18.75% to 81.25%, 50.00%; Acinetobacter baumannii resistance to ceftriaxone and aztreonam reached 100.00%. Coagulase-negative staphylococci, Staphylococcus aureus were found in Gram-positive bacteria. Staphylococcus epidermidis was resistant to penicillin and oxacillin. Among Staphylococcus aureus, the detection rate of MARSA increased from 22.22% to 34.78%. Staphylococcus epidermidis and Staphylococcus aureus were resistant to furantoin, tigacycline, vancomycin and linezolid. Conclusion The pathogen of bloodstream infection was found. Gram-negative bacteria are the main bacteria; pathogenic bacteria are resistant to commonly used antibiotics to varying degrees. Clinical surveillance of bacterial resistance should be strengthened. Clinicians should select antibiotics reasonably according to different bacteria and strictly abide by the guidelines for antibiotics use.
【作者單位】： 成都中醫(yī)藥大學(xué)醫(yī)學(xué)技術(shù)學(xué)院;四川省中醫(yī)院檢驗(yàn)科;
【分類(lèi)號(hào)】：R446.5

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