[1]关佳灏,赵　海,王　翠,等.2018年陕西省人民医院全自动血培养仪及配套鉴定系统分离病原菌的实验室特征及耐药分析[J].现代检验医学杂志,2019,34(06):113-117.[doi:10.3969 ／ j.issn.1671-7414.2019.06.028]
　GUAN Jia-hao,ZHAO Hai,WANG Cui,et al.Laboratory Characteristics and Drug Resistance Analysis of Pathogenic Bacteria Isolated by Automatic Blood Culture Instrument and Matching Idetification System in Shaanxi Provincial People’s Hospital in 2018[J].Journal of Modern Laboratory Medicine,2019,34(06):113-117.[doi:10.3969 ／ j.issn.1671-7414.2019.06.028]
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2018年陕西省人民医院全自动血培养仪及配套鉴定系统分离病原菌的实验室特征及耐药分析 ()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第34卷
期数:
2019年06期
页码:
113-117
栏目:
论著
出版日期:
2019-12-30

文章信息/Info

Title:
Laboratory Characteristics and Drug Resistance Analysis of Pathogenic Bacteria Isolated by Automatic Blood Culture Instrument and Matching Idetification System in Shaanxi Provincial People’s Hospital in 2018
文章编号:
1671-7414（2019）06-113-05
作者:
关佳灏1; 2; 赵　海2; 王　翠2; 马　娟2; 张利侠2
（1. 西安医学院，西安　710021; 2. 陕西省人民医院检验科，西安　710068）
Author(s):
GUAN Jia-hao1; 2; ZHAO Hai1; WANG Cui2; MA Juan2; ZHANG Li-xia2
（1.Xi’an Medical College, Xi’an 710021,China; 2.Department of Clinial Laboratory, Shaanxi Provincial People’s Hospital,Xi’an 710068, China）
关键词:
血流感染; 耐药性; 抗生素; 药敏试验
分类号:
R378；R446.5
DOI:
10.3969 ／ j.issn.1671-7414.2019.06.028
文献标志码:
A
摘要:
目的　分析2018 年陕西省人民医院全自动血培养仪及配套鉴定系统分离病原菌的实验室特征及耐药率分析， 为临床合理用药提供参考。方法　对2018 年陕西省人民医院临床送检的血培养标本中病原菌的分布及耐药率进行回顾 分析。结果　血标本培养的阳性率为9.92%，共分离病原菌962 株，革兰阴性菌598 株、革兰阳性菌354 株、真菌10 株； 其中革兰阴性菌主要为大肠埃希菌占23.0% (221/962) 和肺炎克雷伯菌占18.3% (176/962)；革兰阳性菌主要为表皮葡萄 球菌占10.2% (98/962) 和人葡萄球菌占8.5% (82/962)；真菌主要为白假丝酵母菌占0.6%（6/962）和近平滑假丝酵母菌 占0.4%（4/962）。血培养阳性率较高的科室分别为肝胆外科、急诊外科、血液内科、重症医学科和呼吸内科。大肠埃 希菌和肺炎克雷伯菌对亚胺培南和美罗培南的敏感率为98.2%；葡萄球菌属对万古霉素、利奈唑胺和替加环素的敏感率 为100%。结论　血流感染病原菌主要为革兰阴性菌，其对常用抗生素耐药率较高。临床应重视血培养标本的送检情况 和细菌耐药监测，合理使用抗生素，早期控制血流感染，降低患者的病死率。
Abstract:
Objective　To analysis the distribution and drug resistance of pathogenic bacteria isolated by automatic blood culture instrument and matching identification system in Shaanxi Provincial People’s Hospital in 2018, and provide reference for clinical and rational use. Methods　The distribution and drug resistance rate of pathogenic bacteria in blood culture collected from the Shaanxi Provincial People’s Hospital in 2018 were reviewed and analyzed. Results　The positive rate of blood sample culture was 9.92%,a total of 962 strains of pathogenic bacteria were isolated, in which 598 strains of Gram-negative bacteria,354 strains of Gram-positive bacteria and 10 strains of the fungi.Among them, Gram-negative bacteria were mainly for Escherichia coli accounts was 23.0%(221/962), and Klebsiella pneumoniae accounts for 18.3% (176/962). Among them, Gram-positive bacteria mainly for Staphylococcus epidermidis accounts was 10.2% (98/962) and Staphylococcus human accounts for 8.5% (82/962). The fungi mainly for Candida albicans accounts was 0.6%（6/962）and Candida tropicalis accounts was 0.4%（4/962）.The departments with high positive rate of blood culture were Hepatobiliary Surgery,Emergency Surgery, Hematology Department, Severe Medical Science and Respiratory Medicine Department, respectively.The sensitivity rate of Escherichia coli and Klebsiella pneumoniae to Imipenem and Meropenem were 98.2%,respectively. The sensitivity rate of Staphylococcus to vancomycin,linazolamine and tegacycline was 100%, respectively. Conclusion　The main pathogen of blood flow infection was Gram negative bacteria, the resistance rate to common antibiotics was high.Clinical attention should be paid to the delivery of blood culture specimens and the monitoring of bacterial drug resistance，rational use of antibiotics,early control of blood flow infection,reduce the mortality of patients.blood flow infection and the early treatment of blood flow in clinic,reduce mortality from blood flow infection.

参考文献/References:

[1]　KIRN T J,WEINSTEIN M P.Update on blood cultures:how to obtain,process,report,and interpret[J]. Clin Microbiol Infect,2013,19(6):513-520.
[2]　殷卫兵，严鸣光，方晓，等. 某医院2015 年血培养 分离细菌的分布特征及耐药性分析. 中国疗养医学， 2017,26（4）：445-446. YIN Weibing,YAN Mingguang, FANG Xiao, et al. Distribution characteristics and drug resistance analysis of bacteria isolated from blood culture in 2015 in a hospital[J].Chinese Journal of convalescent Medicine, 2017,26（4）：445-446.
[3]　PEREZ K K,OLSEN R J, MUSICK W L,et al.Integrating rapid pathogen identification and antimicrobial stewardship significantly decreases hospital costs[J].Archives of Pathology & Laoratory Medicine,2013,137(9):1247.
[4]　WU Jiannong, GAN Tieer, ZHU Yuexian, et al.Epidemiology and microbiology of nosocomial bloodstream infections:analysis of 482 cases from a retrospective surveillance study[J].Journal of Zhejiang University-Science B,2015,16(1):70-77.
[5]　尧荣凤, 方慧, 许国祥, 等.2013-2018 年上海某 院血培养病原菌分布和耐药性分析[J]. 检验医 学,2019,34(6):506-512. YAO Rongfeng，FANG Hui, XU Guoxiang, et al.Distribution and drug resistance of pathogens isolated from blood specimens from 2013 to 2018[J].Laboratory medicine, 2019,34(6):506-512.
[6]　张红霞，杨芒庄.1860 例血培养结果及药敏分析[J]. 国际检验医学杂志，2012，33（4）：452-453. ZHANG Hongxia, YANG Mangzhuang. Result and drug sensitivity analysis of 1860 cases of blood culture[J] Internatinal Journal of Laboratory Medicine， 2012，33（4）：452-453.
[7]　高伟. 医院2015 至2016 年血流感染病原菌分布 及耐药性分析[J]. 河北医药,2018,40(21):3333- 3337. GAO Wei. Distribution and antimicrobial resistance of pathogens causing bloodstream infection in a hospital in Ya’an during 2015-2016[J].Hebei Medical, 2018,40(21):3333-3337.
[8]　李小侠, 马娟, 程倩， 等. 成人患者全自动血液 培养病原菌分布及药敏分析[J]. 现代检验医学杂 志,2017,32(06):102-105. LI Xiaoxia,MA Juan,CHENG Qian,et al.Pathogens distribution and drug susceptibility analysis of adults patients by automatic blood culture[J].Journal of Modern Laboratory Medicine,2017,32(4):102-105.
[9]　徐英春, 肖永红, 卓超, 等. 中国碳青霉烯类耐药肠 杆菌科细菌的流行病学和防控策略[J]. 中国执业药 师,2013,10(4):3-8. XU Yingchun, XIAO Yonghong, ZHUO Chao, et al. The epidemiology and prevention strategy of carbapenems resistant Enterobacteriaceae in China[J].Chinese Licensed Pharmacist,2013,10(04):3-8.
[10] 归巧娣, 刘文康, 苍金荣, 等.2013~2015 年陕西省 细菌耐药监测网血培养革兰阳性病原菌变迁及耐 药性分析[J]. 现代检验医学杂志,2017,32(2):89-91. GUI Qiaodi，LIU Wengkang，CANG Jinrong, et al.Drug resistance of pathogens in blood culture speciments in Shaanxi antimicrobial resistant investigation net from 2013 to 2015[J]. Journal of Modern Laboratory Medicine, 2017,32(2):89-91.
[11] 林花，郝东东，许建成. 血培养病原菌药物不敏感 率和污染率分析[J]. 中国实验诊断学，2018，22（7）： 1241-1242. LIN Hua, HAO Dongdong, XU Jiancheng. Analysis of drug insensitivity and contamination rate of pathogenic bacteria in blood culture[J].Chinese Journal of Laboratory Diagnosis, 2018，22（7）：1241-1242.

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备注/Memo

备注/Memo:
作者简介：关佳灏（1993-），女，硕士研究生在读，初级检验师，临床微生物，E-mail:2108173348@qq.com。 通讯作者：张利侠，女，主任技师，硕士生导师，E-mail：2541871021@qq.com 收稿日期：2019-07-29
更新日期/Last Update: 2019-12-25