發(fā)布時間：2018-07-26 10:49

【摘要】：目的了解近3年血培養(yǎng)陽性敗血癥患者病原菌分布及其常見病原菌耐藥特點。方法 284例敗血癥患者血標本在BacT/Alert3D240全自動血培養(yǎng)儀中培養(yǎng),采用Vitek-2全自動細菌鑒定和藥敏系統(tǒng)進行病原菌鑒定,并作藥敏分析。結果 284例敗血癥患者血標本共分離培養(yǎng)出314株病原菌,革蘭陰性菌占69.4%,主要為大腸埃希菌、肺炎克雷伯菌、鮑曼不動桿菌,分別占30.3%、15.9%、6.7%;革蘭陽性菌占29.3%,主要為凝固酶陰性葡萄球菌、金黃色葡萄球菌,分別占15.6%、8.9%;真菌占1.3%。藥敏結果顯示,鮑曼不動桿菌對米諾環(huán)素耐藥率最低為19.1%,對亞胺培南耐藥率達66.7%;肺炎克雷伯菌對除氨芐西林外其它抗菌藥物耐藥率均小于40.0%;銅綠假單胞菌對亞胺培南耐藥率為23.5%;凝固酶陰性葡萄球菌及金黃色葡萄球菌對萬古霉素、利奈唑胺、替加環(huán)素尚未發(fā)現耐藥菌株。結論本研究提示,敗血癥病原菌以革蘭陰性菌為主,耐藥率高,臨床需及時掌握敗血癥的病原菌分布特點及耐藥情況,有針對性選擇抗菌藥物治療具有重要的臨床意義。
[Abstract]:Objective to investigate the distribution of pathogenic bacteria and drug resistance of common pathogens in patients with septicemia in blood culture in recent 3 years. Methods the blood samples of 284 patients with septicemia were cultured in BacT/Alert3D240 automatic blood culture instrument. The pathogens were identified by Vitek-2 automatic bacteria identification and drug sensitivity analysis. Results 314 strains of pathogenic bacteria were isolated from 284 blood samples of septicemia patients. Gram-negative bacteria accounted for 69.4%, mainly Escherichia coli, Klebsiella pneumoniae, Acinetobacter baumannii. Gram-positive bacteria accounted for 29.3, mainly coagulase negative staphylococci, Staphylococcus aureus, accounted for 15.68.9. fungi accounted for 1.3. The results of drug sensitivity showed that The resistance rate of Acinetobacter baumannii to minocycline was the lowest, to imipenem was 66.7, Klebsiella pneumoniae to other antimicrobial agents except ampicillin was less than 40.0. Pseudomonas aeruginosa was resistant to imipenem. Coagulase negative Staphylococcus and Staphylococcus aureus for vancomycin, Linazolamide and tegicycline have not been found to be resistant to the drug. Conclusion this study suggests that Gram-negative bacteria are the main pathogens of septicemia and the drug resistance rate is high. It is necessary to know the distribution characteristics of pathogens and drug resistance in clinical practice. It is of great clinical significance to select antimicrobial agents to treat septicemia.
【作者單位】： 重慶醫(yī)科大學附屬第一醫(yī)院感染科·重慶市傳染病寄生蟲病重點實驗室;
【基金】：國家人事部科研基金(09958013) 重慶市自然科學基金(CSTC2009B5061)
【分類號】：R446.5

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