本文選題：血培養(yǎng) + 病原菌��； 參考：《大連醫(yī)科大學》2015年碩士論文

【摘要】：目的:分析本院2013年1月~2014年12月血培養(yǎng)分離菌的分布及其耐藥性,為臨床合理應用抗菌藥物提供依據(jù)。方法:收集本院2013年1月~2014年12月兩年內(nèi)血培養(yǎng)陽性標本共1534份,采用全自動細菌鑒定及藥敏分析系統(tǒng)WalkAway96 plus、API檢定系統(tǒng)、K-B紙片法、真菌藥敏ATB FUNGUS 3試劑盒對1534例血培養(yǎng)陽性標本進行鑒定和藥物敏感性試驗,藥敏試驗的結(jié)果應用Whonet 5.5軟件對進行統(tǒng)計學分析。結(jié)果:1.血培養(yǎng)分離菌的分布:血培養(yǎng)共獲分離菌1534株,革蘭氏陽性球菌681株,占陽性菌的44.39%,以金黃色葡萄球菌及凝固酶陰性葡萄球菌為主,革蘭氏陰性桿菌806株,占陽性菌的52.55%,以大腸桿菌、非發(fā)酵菌及肺炎克雷伯桿菌為主,真菌27株,占陽性菌的1.76%。2.金黃色葡萄球菌感染在腎內(nèi)科所占科室比率最高,腸桿菌科細菌在泌尿外科分離率最高,非發(fā)酵菌所占科室感染菌比率中急診科/ICU為首位,腸球菌和鏈球菌在心內(nèi)科比例較高。3.血培養(yǎng)分離菌對常用抗生素的敏感性:革蘭陽性菌中,葡萄球菌和腸球菌對青霉素、紅霉素、復方新諾明等有很高的耐藥性,而對萬古霉素、利奈唑胺敏感;屎腸球菌對所測試的大多數(shù)抗菌藥物的耐藥性高于糞腸球菌。大腸桿菌對碳青霉烯類抗生素高度敏感;大腸埃希菌和肺炎克雷伯菌中產(chǎn)超廣譜β-內(nèi)酰胺酶(extended-spectrumβ-lactamases,ESBLs)菌株分別占55.95%和42.5%。銅綠假單胞菌對β-內(nèi)酰胺酶/酶抑制劑類、頭孢吡肟、美洛培南耐藥率均≤30.0%。鮑曼不動桿菌對抗菌藥物耐藥率≤50.0%的有頭孢哌酮/舒巴坦及米諾環(huán)素。結(jié)論:1.血培養(yǎng)最常見的分離菌依次為凝固酶陰性葡萄球菌、大腸埃希菌、鮑曼不動桿菌、肺炎克雷伯桿菌、金黃色葡萄球菌、腸球菌、銅綠假單胞菌。2.葡萄球菌屬細菌中未發(fā)現(xiàn)對萬古霉素和利奈唑胺耐藥株,但MRSA及MRCNS檢出率高。腸桿菌科細菌中產(chǎn)ESBLs菌株以大腸埃希菌和肺炎克雷伯菌所占比例較高,且對碳青霉烯類抗生素高度敏感。
[Abstract]:Objective: to analyze the distribution and drug resistance of isolated bacteria isolated from blood culture in our hospital from January 2013 to December 2014 in order to provide evidence for rational clinical application of antimicrobial agents. Methods: a total of 1534 positive blood samples were collected from January 2013 to December 2014 in our hospital. The automatic bacterial identification and drug sensitivity analysis system (WalkAway96 plusus API test system) were used to detect the positive blood samples by K-B disk method. The fungal ATB FUNGUS 3 kit was used to identify and test the drug sensitivity of 1534 positive blood samples. The results of the drug sensitivity test were analyzed by Whonet 5. 5 software. The result is 1: 1. The distribution of isolated bacteria in blood culture: 1534 strains of isolated bacteria and 681 strains of Gram-positive cocci, accounting for 44.39% of the positive bacteria, mainly Staphylococcus aureus and coagulase-negative staphylococcus, 806 Gram-negative bacilli. E. coli, non-fermentative bacteria and Klebsiella pneumoniae accounted for the majority, and fungi accounted for 27 strains, accounting for 1.76.1% of the positive bacteria. Staphylococcus aureus infection was the highest in the Department of Renal Medicine, Enterobacteriaceae was the highest in urology, non-fermentative bacteria was the first in emergency department / ICU, Enterococcus and Streptococcus were higher in cardiology. In Gram-positive bacteria, Staphylococcus and Enterococcus had high resistance to penicillin, erythromycin and compound sulfamine, but sensitive to vancomycin and linazolamine. The resistance of Enterococcus faecium to most of the antimicrobial agents tested was higher than that of Enterococcus faecalis. Escherichia coli was highly sensitive to carbapenem antibiotics, and extended-spectrum 尾 -lactamase extended-spectrum 尾 -lactamases ESBLsproduced by Escherichia coli and Klebsiella pneumoniae accounted for 55.95% and 42.5%, respectively. The resistance rates of Pseudomonas aeruginosa to 尾 -lactamases / enzyme inhibitors, cefepime and meropenem were all 鈮，

本文編號：1797283