正文描述:《血培养中主要病原菌分布及耐药性分析》由会员上传分享,免费在线阅读,更多相关内容在行业资料-天天文库。
1、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7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CLSI2010标准判断,采用WHONET5.
2、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
3、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AnalysisondistributionanddrugresistanceofpathogenicbacteriainbloodcultureAbstractObjective:Toanalyzethedistributionanddrugresistanceofpathogenicbacteriainbloodculture,andprovideascientificbasisforaccurateclinicaluseofantibi
4、otics.Methods:ByUsingtheBDBACTEC9120automatic(UnitedStates),bloodwascultured,byBD-Phoenix-100automatic,bacterialwereidentified,andbysusceptibilitysystem,positivebloodcultureforbacteriawereidentified,anddrugsensitivitytestswereconducted,drugsusceptibilityresultswereanalyzedbyus
5、ingtheCLSI2010standard,andthedatawasstatisticallyanalyzedbyWHONET5.6software.Results:245strainsofpathogenicbacteriaweredetectedfrom2603casesofbloodculture,thepositiveratewas9.4%,andtherewere91strainsofGram-positivebacteria,accountingfor37.1%,140strainsofGram-negativebacteria,a
6、ccountingfor57.1%,14strainsoffungi,accountedfor5.7%.ThetopfourwereEscherichiacoli,coagulasenegativestaphylococcus,KlebsiellapneumoniaeandStaphylococcusaureus.OfEscherichiacoliandKlebsiellapneumoniae,EscherichiacoliwithproducingESBLsandKlebsiellapneumoniaewithproducingESBLswere
7、65%and44%.Nottoteicoplanin,linezolidandvancomycinresistanceinCNS7andStaphylococcusaureuswasfound.EscherichiacoliandKlebsiellapneumoniaetoimipenem,meropenem,Amikacinhadlowerresistancerateof0.0%-7.9%.Conclusions:Pathogensbloodculturecomplex,thedrugresistancetomainpathogenicbacte
8、riaareinseriouscondition,whichshouldstrengthenthedetectionand
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