急诊创伤患者血标本分离病原菌分布及其耐药性分析

发布时间：2018-07-12 11:02

本文选题：急诊创伤 + 血培养　；参考：《中国消毒学杂志》2017年08期

【摘要】：目的研究急诊创伤患者血标本分离病原菌分布及其耐药性情况,为临床合理应用抗菌药物提供依据。方法通过细菌分离培养和鉴定技术,对北京市某急救中心急诊创伤患者送检血标本进行监测。结果从39 439份血标本中共分离出病原菌2 801株,阳性率为7.1%;剔除重复菌株后,共计1 604株。血液标本分离病原菌中,革兰阳性球菌构成比为48.8%,其中凝固酶阴性葡萄球菌占59.00%,耐甲氧西林金黄色葡萄球菌占39.8%;革兰阴性杆菌占45.8%,真菌占5.4%。葡萄球菌属对万古霉素、利奈唑胺、替考拉宁等均敏感。革兰阴性杆菌中鲍曼不动杆菌和铜绿假单胞菌对碳青霉烯类耐药率超过30%。采血前皮肤清洁方式、导管留置时间比较差异有统计学意义(P0.05)。结论急诊创伤患者血液标本中检出革兰阳性和革兰阴性菌群比例接近,革兰阴性杆菌耐药更为严重。采血前皮肤清洁与动静脉置管长短是导致血培养感染的危险因素,应采取综合预防措施。
[Abstract]:Objective to study the distribution and drug resistance of pathogenic bacteria isolated from blood samples of emergency trauma patients and to provide evidence for rational clinical use of antibiotics. Methods the blood samples of emergency trauma patients in an emergency center in Beijing were monitored by bacteria isolation, culture and identification techniques. Results A total of 2 801 strains of pathogenic bacteria were isolated from 39 439 blood samples with a positive rate of 7.1 and 1 604 strains after repeats were excluded. Among the pathogenic bacteria isolated from blood samples, the composition ratio of Gram-positive cocci was 48.8, among which coagulase-negative staphylococcus accounted for 59.00, methicillin-resistant Staphylococcus aureus for 39.8, Gram-negative bacilli for 45.8 and fungi for 5.4B. Staphylococcus is sensitive to vancomycin, linazolamine and teicoplanin. The resistance rate of Acinetobacter baumannii and Pseudomonas aeruginosa to carbapenem in Gram-negative bacilli was more than 30. Before blood collection, there were significant differences in skin cleaning and catheter indwelling time (P0.05). Conclusion the proportion of Gram-positive and Gram-negative bacteria in the blood samples of emergency trauma patients is close to that of Gram-negative bacilli, and the drug resistance of Gram-negative bacilli is more serious. The cleaning of skin and the length of arteriovenous catheterization before blood collection are the risk factors of blood culture infection, so comprehensive preventive measures should be taken.
【作者单位】：北京市朝阳区医院管理中心;
【分类号】：R446.5;R641

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