血流感染中耐药菌与敏感菌PCT水平的差异研究

发布时间：2018-01-18 07:07

本文关键词：血流感染中耐药菌与敏感菌PCT水平的差异研究　出处：《中华医院感染学杂志》2017年20期 　论文类型：期刊论文

【摘要】：目的探讨降钙素原(PCT)在血流感染中对大肠埃希菌和产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌、金黄色葡萄球菌和耐甲氧西林金黄色葡萄球菌(MRSA)的鉴别和分类价值。方法采用回顾性研究选择医院2015年1月-12月期间住院患者血培养标本5646例,符合标本1658例,其中血培养阴性组1426例,血培养阳性组232例;排除污染后,血培养阳性组中革兰阴性菌96例,革兰阳性菌82例;用全自动电化学发光仪检测PCT,用全自动细菌分枝杆菌培养监测系统进行血培养,用全自动微生物鉴定仪进行细菌培养和鉴定。结果 PCT鉴别性能的ROC曲线鉴别血培养阳性和阴性的敏感度和特异度分别为78.40%和62.00%;感染革兰阴性菌患者PCT(37.42±13.55)ng/ml显著高于革兰阳性菌患者(11.22±3.56)ng/ml(P0.05),且当PCT10.0ng/ml时,革兰阴性菌的数量明显高于革兰阳性菌(P0.05);ESBLs的大肠埃希菌PCT的均值明显高于大肠埃希菌,MRSA PCT均值明显低于金黄色葡萄球菌(P0.05)。结论血流感染时PCT的水平有助于快速区分革兰阴性菌和革兰阳性菌;当PCT10.0ng/ml时,革兰阴性杆菌感染的可能性极高;并且产ESBLs的大肠埃希菌患者的PCT水平高于大肠埃希菌患者,MRSA患者的PCT水平低于金黄色葡萄球菌患者。
[Abstract]:Objective to investigate the effect of procalcitonin (PCT) on Escherichia coli and extended-spectrum 尾 -lactamase producing Escherichia coli in blood stream infection. Staphylococcus aureus and methicillin-resistant Staphylococcus aureus. Methods A retrospective study was conducted to select 5 646 blood culture specimens from hospital patients from January 2015 to December. There were 1658 conformable specimens, including 1426 cases in negative blood culture group and 232 cases in positive blood culture group. After removing contamination, 96 cases of Gram-negative bacteria and 82 cases of Gram-positive bacteria were found in the positive group of blood culture. PCT was detected by automatic electrochemiluminescence instrument and blood culture was carried out by the automatic monitoring system of mycobacterium culture. Culture and identification of bacteria by automatic microbiological identification instrument. Results. The sensitivity and specificity of positive and negative blood culture by ROC curve were 78.40% and 62.00, respectively. PCT(37.42 卤13.55 ng / ml in patients infected with Gram-negative bacteria was significantly higher than that in patients with Gram-positive bacteria (11.22 卤3.56 ng / ml P0.05). When PCT10.0ng/ml, the number of Gram-negative bacteria was significantly higher than that of Gram-positive bacteria (P0.05). The mean value of Escherichia coli PCT in ESBLs was significantly higher than that in Escherichia coli. The mean value of MRSA PCT was significantly lower than that of Staphylococcus aureus P0.05.Conclusion the level of PCT in blood stream infection is helpful to distinguish Gram-negative bacteria from Gram-positive bacteria. When PCT10.0ng/ml, Gram-negative bacilli were highly likely to be infected; The level of PCT in ESBLs producing Escherichia coli patients was higher than that in Staphylococcus aureus patients.
【作者单位】：华中科技大学同济医学院附属武汉中心医院检验科;
【分类号】：R446.5
【正文快照】： 血流感染是细菌或真菌侵入血流而引起的严重的全身感染性疾病,发病急,病死率高。近年来,随着广谱抗菌药物的广泛应用,细菌耐药性逐年增长,耐药菌已成为院内感染的主要病原菌[1],尤其是多药耐药菌(MDR)。多药耐药菌,主要是指对临床使用的三类或三类以上抗菌药物同时呈现耐药的

【相似文献】