摘要
目的分析2389例血液标本培养中病原菌分离鉴定以及病原菌耐药性的情况,为临床治疗感染性疾病制定诊疗方案及合理用药提供参考依据。方法回顾性分析2014年6月至2016年5月本院用迪尔DL-Bt64(DLBt64)全自动血培养仪对2389例血液标本培养分离致病菌和用DL-96Ⅱ细菌测定系统进行细菌鉴定和药敏试验的结果。结果分离出病原菌213株,培养阳性率为8.92%。其中G+菌109株占51.17%(109/213),G-杆菌87株占40.85%(87/213),真菌17株占7.98%(17/213)。G+菌中以凝固酶阴性葡萄球菌和金黄色葡萄球菌为主,检出率分别为24.88%和14.55%,其他菌株均小于5.00%。G-菌中以大肠埃希菌、肺炎克雷伯菌和铜绿假单胞菌为主,检出率分别为15.69%、9.86%和7.04%,其他菌株均小于3.00%。真菌以白色念珠菌为主,检出率为6.10%,其他菌株均小于2.00%。凝固酶阴性葡萄球菌对苯唑西林、青霉素G的耐药率在为90.0%以上,未发现万古霉素、利奈唑胺和替考拉宁对葡萄球菌的耐药。大肠埃希氏菌对复方新诺明、阿米卡星、头孢呋辛、左氧氟沙星,肺炎克雷伯菌对阿米卡星、哌拉西林、头孢噻肟、头孢呋辛以及铜绿假单胞菌对复方新诺明、阿米卡星、头孢曲松、头孢噻肟、左氧氟沙星的耐药率均在50.00%以上,白色念珠菌对益康唑和制菌霉素的耐药率均在68.00%以上。结论血培养致病菌以G+菌为主,菌种多样化,细菌耐药情况较为严重。临床应加强血培养对致病菌鉴定,定期分析本区域致病菌耐药结果,对治疗感染性疾病时制定诊疗方案、避免抗菌药物的滥用、降低耐药菌株的产生等方面具有极其重要的应用价值。
Objective To analyze the isolation and identification of pathogenic bacteria and drug resistance of pathogenic bacteria in 2389 cases of blood samples,and to provide reference for clinical treatment of infectious diseases and rational drug use.Methods A retrospective analysis from June 2014 to May 2016 in our hospital with dir DL-Bt64（DL-Bt64）testing in 2389 cases of blood samples were isolated and cultured with DL-96 II and pathogenic bacteria identification and drug sensitive test of bacteria testing system of automatic blood culture results.Results Isolated 213 strains of pathogenic bacteria,the positive rate was 8.92%.Among them,109 strains of G＋ bacteria accounted for51.17%（109/213）,87 strains of G-were 40.85%（87/213）,and 17 strains of fungi accounted for 7.98%（17/213）.G＋ bacteria with coagulase negative Staphylococcus and Staphylococcus aureus.The detection rates were 24.88% and14.55%,other strains were less than 5.00%.In G-bacteria,Escherichia coli,Klebsiella pneumoniae and Pseudomonas aeruginosa,the detection rates were 15.69%,9.86% and 7.04%,respectively,and the other strains were less than3.00%.Fungi were mainly Candida albicans,the detection rate was 6.10%,the other strains were less than 2.00%.Coagulase negative Staphylococcus aureus to oxacillin,penicillin resistant G at the rate above 90%,no vancomycin,linezolid and teicoplanin resistance of Staphylococcus aureus.Escherichia coli to cotrimoxazole,levofloxacin,Amikacin,cefuroxime,Klebsiella pneumoniae to Amikacin,piperacillin,cefotaxime and cefuroxime and Pseudomonas aeruginosa to cotrimoxazole,Amikacin,ceftriaxone,cefotaxime,levofloxacin resistance rate was more than 50%,The resistant rate of Candida albicans to the benefit of the drug and the preparation of the bacteria were above 68%.Conclusion Blood culture pathogenic bacteria with G＋bacteria,bacterial diversity,bacterial drug resistance is more serious.The identification of pathogenic bacteria in blood culture should be strengthened,and the results of drug resistance of pathogenic bacteria in the area should be analyzed regularly,It has important application value in the treatment of infectious diseases,the development of diagnostic and treatment programs,to avoid the abuse of antibiotics and reduce the production of drug resistant strains.
作者
高建萍
龙训琴
陈俊莉
GAO Jian-ping LONG Xun-qin CHEN Jun-li.(Clinical Laboratory, Chengdu West Hospital, Chengdu 610041, China)
出处
《中国实验诊断学》
2017年第4期597-600,共4页
Chinese Journal of Laboratory Diagnosis
关键词
血液培养
主要致病菌
耐药性
全自动血培养系统
blood culture
Main pathogenic bacteria
tolerance
Automated blood culture system
