1.Pathogen distribution of 3 164 blood samples and drug resistance analysis
Jie WANG ; Fangjiu LIU ; Wufang XIONG ; Jiarui LIU
International Journal of Laboratory Medicine 2014;(24):3385-3387
Objective To understand the distribution of detected pathogens in blood culture specimens in our hospital and the drug resistance to provide the basis for clinical reasonable selection of antibacterial drugs.Methods The blood culture results in our hospital from January 2011 to June 2012 were analyzed retrospectively.Results Among 3 164 blood culture samples,418 cases were positive,accounting for 13.21%,176 strains were Gram-positive bacteria(42.11%),Staphylococcus aureus and coagulase neg-ative staphylococcus were predominant;235 stains were Gram-negative bacteria(56.22%),Escherichia coli and Klebsiella pneumon-iae were predominant;7 stains were Candida(1.67%).The most of submitted specimens were the neonatology department(627 specimens),hematology department (367 specimens),respiratory department (272 specimens),paediatric department (207 speci-mens),neurology department(185 specimens)and ICU(158 specimens).The top departments in the strain separation rate were the hepatobiliary surgery(22.22%),endocrinology(18.18%),spinal surgery(16.36%),ICU(15.96%),neurosurgery(15.62%),neu-rology(15.13%),oncology(13.92%),urological surgery (12.23%),burns and pediatric surgery (12.15%),and bone surgery (10.25%).Among mainly Gram-positive bacteria,Staphylococcus had the high resistance to penicillin,erythromycin,clindamycin and trimethoprim-sulfamethoxazole,coagulase-negative staphylococci had the high resistance to quinoiones,but vancomycin-resistant and linezolid-resistant Staphylococcus was not found.Among Gtam-negative bacilli,Enterobacteriaceae had the strong sensitivity to imipenem,ertapenem and amikacin;Escherichia coli had the higher resistance to penicillins,cephalosporins,aztreonam,quinolones, cotrimoxazole,gentamicin and tobramycin,which was more than 40%,the resistance rate to ampicillin,ampicillin/sulbactam was a-bout 90%,but Escherichia coli was more sensitive to piperacillin / tazobactam,the resistance rate was less than 5%;Klebsiella pneumoniae had the low drug resistance,only the resistance rates to ampicillin and nitrofurantoin were more than 90%,the others were 30 % or less;Enterobacter cloacae had the higher resistance to ampicillin,ampicillin/sulbactam,third generation cephalospo-rins,tobramycin,cefotetan and nitrofurantoin and the low resistance to the fourth generation cephalosporins,piperacillin / tazobac-tam and quinolones.Conclusion The pathogenic bacterial species of blood culture are complex and dominated by the conditional pathogens with strong drug resistance.Therefore,the detection of clinical blood culture specimens in the patients with suspected septicemia should be strengthened for accurately and rationally using antibacterial drugs as early as possible and increasing the cure rate.