血培养中主要病原菌分布及耐药性分析.doc

分类号： R4 单位代码： 113 密 级： 一般 学 号：1130409014053 本科毕业论文 题 目：血培养中主要病原菌 分布及其耐药性分析 专 业： 医学检验 姓 名： 杨俊龙 指导教师： 张志明 职 称： 副主任检验师 答辩日期： 2013年5月30日 血培养中主要病原菌分布及其耐药性分析 摘要 目的：分析血培养中主要病原菌分布及耐药性情况，为临床准确使用抗生素提供科学依据。方法: 采用美国BD公司BACTEC9120全自动血液培养仪进行培养，BD-Phoenix-100全自动细菌鉴定/药敏系统对血培养阳性标本进行细菌鉴定及药敏试验，药敏结果采用CLSI 2010标准判断，采用WHONET5.6软件统计分析结果。结果: 2603例血培养共检出245株病原菌，阳性率为9.4％，其中革兰阳性菌91株，占37.1％，革兰阴性菌140株，占57.1％，真菌14株，占5.7％。居前四位的依次是大肠埃希菌、凝固酶阴性葡萄球菌、肺炎克雷伯菌、金黄色葡萄球菌。产ESBLs的大肠埃希菌和肺炎克雷伯菌分别占大肠埃希菌和肺炎克雷伯菌的65％和44％。未发现对替考拉宁、利奈唑安和万古霉素耐药的CNS和金黄色葡萄球菌。大肠埃希菌和肺炎克雷伯菌对亚胺培南、美罗培南、阿米卡星耐药率较低0.0％-7.9％。结论: 血培养病原菌种类复杂，主要病原菌耐药情况严重，应加强早期检测和耐药性分析，指导临床医生准确使用抗菌药物，防止抗生素的滥用及耐药菌株的产生。 关键词 血培养；病原菌；耐药性 Analysis on distribution and drug resistance of pathogenic bacteria in blood culture Abstract Objective: To analyze the distribution and drug resistance of pathogenic bacteria in blood culture, and provide a scientific basis for accurate clinical use of antibiotics. Methods: By Using the BD BACTEC9120 automatic (United States), blood was cultured, by BD-Phoenix-100 automatic, bacterial were identified, and by susceptibility system, positive blood culture for bacteria were identified, and drug sensitivity tests were conducted, drug susceptibility results were analyzed by using the CLSI 2010 standard, and the data was statistically analyzed by WHONET5.6 software. Results: 245 strains of pathogenic bacteria were detected from 2603 cases of blood culture, the positive rate was 9.4%, and there were 91 strains of Gram-positive bacteria, accounting for 37.1%, 140 strains of Gram-negative bacteria, accounting for 57.1%, 14 strains of fungi, accounted for 5.7%. The top four were Escherichia coli, coagulase negative staphylococcus, Klebsiella pneumoniae and Staphylococcus aureus. Of E