摘要
Abstract
Objective To investigate the distribution and resistance of positive pathogens isolated from blood culture and guide the use of antibiotics for clinic.Methods Collect the blood samples from 2012 to 2013 and cultivate by BD 9240,pathogenic bacteria was identified by VITEC 2-Compact automated system.Antimicrobial susceptibility testing was carried out according to Kirby-Bauer method or automated systems.Results were analyzed according to the breakpoints of CLSI 2012.Results Among the 7874 blood culture samples,746 cases showed positive and the pos-itive rate was 9.5%.There was a total of 475 positive samples by analyzing patients and rejecting the repeat samples. Among the strains,the percentage of the Gram-positive bacteria,gram-negative bacteria and fungi were 47.0%(223/475),50.7%(241/475)and 2.3% (11/475)respectively.In the Gram-positive bacteria,the predominant bacteria were coagulase-negative Staphylococcus(32%),S.aureus(4%),Streptococcus(7.8%)and Enterococcus(2.3%), while among the Gram-negative bacteria,the predominant bacteria were Escherichia coli(23%),klebsiella pneumoniae (12%),Acinetobacter baumannii (4%),enterobacter cloacae(3%)and Pseudomonas aeruginosa(1%)and Candida albicans(0.6%),candida parapsilosis(0.9%)were the predominant fungi.There were 4 strains of anaerobic bacteria including bacteroides fragilis(2 strains),Bacteroides thetaiotaomicron(1 strain),clostridium perfringens(1 strain) while 5 strains of rare pathogens including streptococcus suis(2 strains),Brucella(1 strain),Nocardia(1 strain)and Penicillium marneffei(1 strain).The prevalence of ESBLs producing strains was 47.5 in E.coli,16.7 in K.pneumoni-ae.The average prevalence of methicillin-resistant strains in S.aureus(MRSA)and coagulase-negative Staphylococ-cus(MRCNS)was 35.0% and 78.0% respectively.Enterobacteriaceae strains were still highly susceptible to the three carbapenems tested,the overall resistance rates were less than 4%.The main carbapenems resistant strain was K.pneumoniae which had reached up to 3.6% to Meropenem.Acinetobacter bauamnnii and Pseudomonas aeruginosa had a relatively high resistance to many antimicrobial drugs.There was no resistance to vancomycin and linezolid in Staphylococcus.Conclusion The contamination rate of blood culture was high and the specification of blood collec-tion should be strengthen.There was a variety of pathogens leading to bloodstream infection which show a high re-sistance to many antimicrobial agents.Strengthening surveillance.关键词
血培养/病原菌/分布/耐药性Key words
blood culture/pathogen/distribution/resistance
