儿童和成人血液病患者血培养病原菌分布及耐药性分析

发布时间：2018-03-30 03:00

本文选题：血培养　切入点：细菌　出处：《国际检验医学杂志》2017年07期

【摘要】：目的了解儿童和成人血液病患者血流感染的病原菌分布及耐药性,为减少血流感染、合理用药提供依据。方法对该院2015年1月至2016年5月儿童及成人住院患者送检的血培养标本,使用BACTEC-9120及BACTEC-9240全自动血培养仪培养,用VITEK2全自动微生物鉴定系统进行菌种鉴定和药敏试验。结果儿童和成人血培养阳性率分别为8.38%和9.15%。儿童革兰阳性菌占55.6%,阴性菌占44.4%。成人革兰阳性菌占24.6%,阴性菌占74.1%,真菌1.8%。成人和儿童大肠埃希菌中产超广谱β内酰胺酶(ESBL)的构成比分别为52.3%和48.3%。产ESBL的肺炎克雷伯构成比为25.7%和5.9%。成人大肠埃希菌对阿莫西林/克拉维酸、氨苄西林/舒巴坦、哌拉西林/他唑巴坦、头孢他啶、头孢唑肟、头孢吡肟、氨曲南、妥布霉素、左氧氟沙星、莫西沙星、诺氟沙星、复方磺胺甲VA唑的耐药率均高于儿童。结论血液病患儿血培养以革兰阳性菌为主,凝固酶阴性葡萄球菌(CNS)占第一位,成人血培养以革兰阴性杆菌为主,大肠埃希菌占第一位。对革兰阴性杆菌,儿童和成人患者部分药物存在差异,应根据药敏试验结果合理选用抗菌药物。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance of blood stream infection in children and adults with hematologic diseases, so as to reduce blood flow infection. Methods from January 2015 to May 2016, the blood culture specimens of children and adults hospitalized in our hospital were cultured with BACTEC-9120 and BACTEC-9240 automatic blood culture instrument. The results showed that the positive rates of blood culture in children and adults were 8.38% and 9.15 respectively. The percentage of Gram-positive bacteria in children was 55.6%, negative bacteria was 44.4%, adult Gram-positive bacteria was 24.6g and negative bacteria was 9.15.The results showed that the positive rates of blood culture in children and adults were 8.38% and 9.15 respectively. The proportions of extended-spectrum 尾 -lactamases (ESBLs) of Escherichia coli in adults and children were 52.3% and 48.3%, respectively. The proportions of Klebsiella pneumoniae producing ESBL were 25.7% and 5.9%, respectively. Ampicillin / sulbactam, piperacillin / tazobactam, ceftazidime, cefazoxime, cefepime, aztreonam, tobramycin, levofloxacin, moxifloxacin, norfloxacin, Conclusion Gram-positive bacteria is the main blood culture in children with hematologic diseases, and coagulase negative staphylococcus staphylococcus (CNS) is the first, and Gram-negative bacilli are the main blood cultures in adults. Escherichia coli occupied the first place. For Gram-negative bacilli, children and adults, some drugs were different, so the antimicrobial agents should be reasonably selected according to the results of drug sensitivity test.
【作者单位】：中国医学科学院血液病医院临床检测中心;
【分类号】：R446.5

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