2013—2015年血培养主要病原菌分布及药物敏感性分析

发布时间：2018-07-12 12:55

本文选题：血培养 + 双侧双瓶　；参考：《南京医科大学学报(自然科学版)》2017年10期

【摘要】：目的:统计分析2013—2015年南京医科大学第一附属医院血培养主要病原菌分布及药物敏感性变迁情况。方法:血培养采用BACTEC FX全自动血培养仪;细菌和真菌鉴定及药物敏感试验采用VITEK-2 Compact全自动微生物鉴定及药敏系统,链球菌药敏为纸片扩散法(K-B法),真菌药敏采用ATB FUNGUS 3方法,WHONET5.6软件进行统计分析。结果:2013—2015年南京医科大学第一附属医院血培养阳性率10.4%(2 056/19 799),双侧双瓶采血的标本阳性率显著高于单侧双瓶/双侧单瓶和单瓶采血组(P0.01)。前5位病原菌分别是大肠埃希菌(21.3%)、肺炎克雷伯菌(11.4%)、金黄色葡萄球菌(6.0%)、凝固酶阴性葡萄球菌(5.4%)和铜绿假单胞菌(4.3%)。肠杆菌科细菌对碳青霉烯类药物敏感性最高(60%),但耐药株逐渐增多,尤其是耐碳青霉烯肺炎克雷伯菌。铜绿假单胞菌对除氨曲南以外的抗菌药物均有较好的敏感性(70%),而鲍曼不动杆菌对常见抗菌药物敏感性均较低(40%)。革兰阳性球菌对万古霉素、利萘唑胺和替考拉宁敏感性较好。结论:双侧双瓶血培养的采血模式有助于提高血培养阳性率,监测污染率。血流感染病原菌中多重耐药株有增多趋势,加强抗菌药物管理和感染控制有重要意义。
[Abstract]:Objective: to analyze the distribution of main pathogenic bacteria and the changes of drug sensitivity in blood culture of the first affiliated Hospital of Nanjing Medical University from 2013 to 2015. Methods: BACTEC FX automatic blood culture instrument was used for blood culture, and VITEK-2 Compact automatic microorganism identification and drug sensitivity system were used for bacteria and fungi identification and drug sensitivity test. The susceptibility of streptococcus was determined by disk diffusion method (K-B method) and fungal susceptibility was analyzed by ATB FUNGUS3 method and WHONET5.6 software. Results the positive rate of blood culture in the first affiliated Hospital of Nanjing Medical University from 2013 to 2015 was 10.4% (2 056 / 19 799). The top five pathogens were Escherichia coli (21.3%), Klebsiella pneumoniae (11.4%), Staphylococcus aureus (6.0%), coagulase negative Staphylococcus (5.4%) and Pseudomonas aeruginosa (4.3%). Enterobacteriaceae was the most sensitive to carbapenems (60%), but the resistant strains increased gradually, especially Klebsiella pneumoniae. Pseudomonas aeruginosa had a good sensitivity to antibiotics except aztreonam (70%), while Acinetobacter baumannii was less sensitive to common antimicrobial agents (40%). Gram-positive cocci were more sensitive to vancomycin, rinazolamine and teicoplanin. Conclusion: the blood collection model of bilateral two-bottle blood culture is helpful to increase the positive rate of blood culture and monitor the contamination rate. There is an increasing trend of multidrug resistant strains in pathogenic bacteria of blood stream infection. It is important to strengthen the management of antibiotics and control of infection.
【作者单位】：南京医科大学第一附属医院检验学部;
【基金】：江苏省实验诊断学重点实验室基金(xk201114) 南京医科大学“十二五”教育研究课题(JYY2015020)
【分类号】：R446.5

【相似文献】