200例败血症病原菌分布特征及耐药性分析

发布时间：2018-01-24 02:50

本文关键词： 出血性败血症病毒性病原菌分布特征耐药性分析　出处：《中国全科医学》2017年S1期 　论文类型：期刊论文

【摘要】：目的探究我院200例败血症患者病原菌的种类及构成比,并通过耐药性分析探究主要菌种的耐药率,为败血症的临床诊断与治疗提供理论依据。方法选择2014年2月—2017年2月于武汉大学人民治疗的200例败血症患者,所有患者均进行血液标本采集,通过BD9120全自动血培养仪进行细菌分离培养,观察病原菌种类及构成比等分布特征。采用美国BD全自动微生物鉴定药敏分析系统进行耐药性分析,分别检测革兰阳性菌以及革兰阴性菌主要菌种对一般抗菌药物的耐药性。结果 200例败血症患者的血液标本中总检出病原菌220株,其中革兰阴性菌所占比例最大,共143株(占65.00%);其中排名前4位分别为肺炎克雷伯菌、大肠埃希菌、铜绿假单胞菌以及阴沟杆菌,所占比例分别为18.18%(40/220)、17.27%(38/220)、6.36%(14/220)、5.45%(12/220)。革兰阳性菌65株(29.55%);其中排名前3位分别为凝固酶阴性葡萄球菌、金黄色葡萄球菌以及肠球菌属,所占比例分别为17.73%(39/220)、5.45%(12/220)、4.55%(10/220)。真菌12株(占5.45%)。革兰阴性菌中大肠埃希菌超广谱β-内酰胺酶检出率为68.42%(26/38)、肺炎克雷伯菌为22.50%(9/40),革兰阳性菌中金黄色葡萄球菌甲氧西林耐药株比例为25.00%(3/12)、凝固酶阴性葡萄球菌为82.05%(32/39);败血症患者血液内革兰阴性菌、革兰阴性菌主要菌株对常用抗菌药物均表现出不同程度的耐药性,分别对亚胺培南、万古霉素敏感性最高。结论感染败血症患者病原菌以革兰阴性菌为主,其次为革兰阳性菌,真菌感染所占比例极小,耐药性分析分析情况不容乐观,对常用抗菌药物均表现出不同程度的耐药性,临床上需要根据病原菌分布特征及耐药性分析结果使用合理的抗生素治疗,同时要避免抗生素的不规范使用。
[Abstract]:Objective to investigate the types and composition of pathogens in 200 patients with septicemia in our hospital, and to explore the drug resistance rate of the main strains by drug resistance analysis. Methods 200 cases of septicemia treated in Wuhan University from February 2014 to February 2017 were selected. Blood samples were collected from all patients and bacteria were isolated and cultured by BD9120 automatic blood culture instrument. To observe the distribution characteristics of pathogen species and composition ratio, the drug resistance analysis system of American BD automatic microorganism identification system was used for drug resistance analysis. The antimicrobial resistance of Gram-positive bacteria and Gram-negative bacteria to general antimicrobial agents were detected respectively. Results 220 strains of pathogenic bacteria were detected in blood samples of 200 patients with septicemia. The proportion of Gram-negative bacteria was the largest, 143 strains (65.00%). The top 4 were Klebsiella pneumoniae, Escherichia coli, Pseudomonas aeruginosa and Clostridium cloacae respectively, accounting for 18.1840 / 220). 17.27% 38 / 220 / 6.36 / 14 / 220 / 5.45 / 12 / 2200.65 strains of Gram-positive bacteria were found to be 29.55; The top three were coagulase-negative staphylococci, Staphylococcus aureus and Enterococcus, respectively, accounting for 17.73% 39 / 220 / 5.45 / 220). 4.55 there were 12 strains of fungi (5.450.The detection rate of extended-spectrum 尾 -lactamases in Gram-negative bacteria was 68.42%). Klebsiella pneumoniae was 22.500.The proportion of methicillin resistant strains of Staphylococcus aureus in Gram-positive bacteria was 25.00 / 12). Coagulase negative staphylococcus was 82.05 / 32 / 39; Blood Gram-negative bacteria and Gram-negative bacteria of septicemia patients, the main strains of Gram-negative bacteria showed different degrees of resistance to commonly used antibiotics, respectively to imipenem. Conclusion Gram-negative bacteria are the main pathogens in patients with septicemia, followed by gram-positive bacteria. The proportion of fungal infection is very small. The analysis of drug resistance is not optimistic. It is necessary to use reasonable antibiotics according to the distribution characteristics of pathogens and the results of drug resistance analysis, and avoid the irregular use of antibiotics.
【作者单位】：武汉大学人民医院检验科;
【分类号】：R446.5;R515.3
【正文快照】： 败血症是指人体血液循环受到致病菌或者条件致病菌的侵结膜等出现瘀点,肝脾大、皮疹、脓肿或迁徙性损害。入,并于血液中生长繁殖,通过其产生的毒素导致急性全身性1.2方法采血过程参照医院标准采血程序,血液采集后分感染,临床上出现高热、心肌炎、感染性休克等。当人体防御别注

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