论文部分内容阅读
目的按照不同原发病及年龄分层统计、分析血液病患者血培养分离菌分布和药敏结果,为临床合理使用抗菌药物提供依据。方法对血液科2013年1月-2014年12月血培养标本的结果和患者的一般资料进行回顾性分析。结果共送检1 695份血培养标本,阳性标本302份,阳性率为17.8%,分离到113株革兰阳性菌(37.4%),170株革兰阴性菌(56.3%),19株真菌(6.3%)。血培养阳性率最高的原发病是骨髓瘤(26.5%),其次是白血病(24.3%)。年龄分组中60~80岁患者血培养阳性率为17.9%,<60岁阳性率为17.8%。血培养阳性标本中,革兰阳性菌阳性率最高的年龄段为60~80岁,阳性率为39.5%。革兰阳性菌中以葡萄球菌属居首,革兰阴性菌中肠杆菌科细菌最多。革兰阳性菌对万古霉素、替加环素有较高的敏感率,革兰阴性菌对亚胺培南、头孢替坦有较高的敏感率。葡萄球菌属和肠球菌属对青霉素G均有较高耐药率。结论 1 695份血液科患者血培养阳性标本分析显示革兰阴性菌,尤其是大肠埃希菌在血流感染中占多数。血培养分离菌对常见抗菌药物耐药率较高,而检出原发病最多为骨髓瘤;60~80岁患者比率最高。对不同原发病、年龄分层血培养分离菌的分布和敏感及耐药性进行分析,有助于指导临床合理用药。
Objective To analyze the distribution of blood culture isolates and susceptibility results of patients with blood diseases according to the stratified statistics of different primary diseases and ages so as to provide basis for the rational use of antibacterial drugs in clinic. Methods Retrospective analysis was performed on the results of blood culture samples from January 2013 to December 2014 in hematology department and the general data of patients. Results A total of 1 695 blood culture specimens were collected and 302 positive specimens were positive. The positive rate was 17.8%. 113 Gram-positive bacteria (37.4%), 170 Gram-negative bacteria (56.3%), 19 fungi 6.3%). The primary positive rate of blood culture was myeloma (26.5%), followed by leukemia (24.3%). The positive rate of blood culture in 60 ~ 80 years old patients in age group was 17.9%, the positive rate of <60 years old was 17.8%. Blood culture positive specimens, the highest positive rate of Gram-positive bacteria in the age range of 60 to 80 years, the positive rate was 39.5%. Gram-positive bacteria in Staphylococcus genus, Gram-negative bacteria Enterobacteriaceae bacteria most. Gram-positive bacteria vancomycin, tigecycline have a higher sensitivity rate, gram-negative bacteria on imipenem, cefotetan have a higher sensitivity. Staphylococcus and Enterococcus genus Penicillin G have a higher resistance rate. Conclusions An analysis of 1 695 blood culture positive specimens from patients with hematologic diseases shows that Gram-negative bacteria, especially Escherichia coli, account for the majority of bloodstream infections. Blood culture isolates of common antimicrobial resistance rate is higher, while the detection of primary disease up to myeloma; the highest rate of 60 to 80-year-old patients. Analysis of the distribution and sensitivity and drug resistance of different primary disease and age stratified blood culture bacteria helps to guide clinical rational drug use.