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[目的]了解我院慢性阻塞性肺病合并血液感染患者于2006～2008年9月血培养标本中分离菌的分布及耐药性,为临床治疗提供用药依据。[方法]血培养用BacT/ALERT120全自动血培养仪,阳性者再用MicroScan公司的autoSCAN-4全自动微生物分析系统进行细菌鉴定及药敏分析。[结果]2006～2008年9月呼吸病科血培养标本共1445例,分离菌株172株,总阳性率11.9%。常见分离菌中有凝固酶阴性葡萄球菌、金黄色葡萄球菌、肠球菌、大肠埃希氏菌、肺炎克雷伯菌及沙门菌属等。其中革兰阳性菌102株,分离率为7.1%,主要为凝固酶阴性葡萄球菌,占总病原菌的33.1%,其次是金黄色葡萄球菌,占总病原菌的13.4%;革兰阴性菌55株,分离率为3.8%,以大肠埃希菌检出率较高,占病原菌的14.5%;真菌4株,分离率为0.3%,其他菌11株,分离率为0.8%。血培养中葡萄球菌对万古霉素较为敏感;革兰阴性杆菌对亚胺培南、阿米卡星、哌啦西林/他唑巴坦较为敏感。[结论]COPD合并血液感染者应加强血培养中病原菌及其对抗菌药物的耐药性监测。
[Objective] To understand the distribution and drug resistance of isolated bacteria in blood culture specimens from 2006 to 2008 in patients with chronic obstructive pulmonary disease and blood infection in our hospital, and to provide basis for clinical treatment. [Method] BacT / ALERT120 automatic blood culture instrument was used in blood culture. The bacteria were identified and susceptible to drug analysis by MicroScan autoSCAN-4 automatic microbiological analysis system. [Results] A total of 1445 blood culture specimens were collected from respiratory department in 2006 ~ 2008, and 172 strains were isolated, the total positive rate was 11.9%. Common isolates of coagulase-negative Staphylococcus aureus, Staphylococcus aureus, Enterococcus, Escherichia coli, Klebsiella pneumoniae and Salmonella and so on. 102 Gram-positive bacteria, the isolation rate was 7.1%, mainly coagulase-negative Staphylococcus, accounting for 33.1% of the total pathogens, followed by Staphylococcus aureus, accounting for 13.4% of the total pathogen; Gram-negative bacteria 55, The isolation rate was 3.8%. The detection rate of Escherichia coli was high, accounting for 14.5% of the pathogen; 4 strains of fungi, the isolation rate was 0.3%, 11 strains of other bacteria, the isolation rate was 0.8%. Staphylococcus aureus in blood culture is more sensitive to vancomycin; Gram-negative bacilli are more sensitive to imipenem, amikacin, piperacillin / tazobactam. [Conclusion] The pathogenic bacteria in blood culture should be strengthened and the drug resistance to antibacterials should be monitored in COPD patients with blood infection.