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目的探讨血培养报阳时间在临床鉴别感染菌和污染菌中的意义。方法对医院2015年1月-8月送检12 861份血培养中分离的1 300株阳性菌株的报阳时间、实验室数据及临床资料进行综合分析,并且将1 254株细菌分成感染菌组892株和污染菌组362株。结果 1 300株阳性分离菌中,主要为大肠埃希菌占30.31%,其次是凝固酶阴性葡葡球菌占26.46%;且高于感染菌组,两组比较有统计学差异(P<0.05),血培养报阳时间0~12h共检出47.1%、污染占4.1%,其中金黄色葡萄球菌、肺炎链球菌、鲍氏不动杆菌等均为感染菌,占100%;13~24h检出31.7%、污染占42.1%;25~48h检出15.0%、污染占60.6%;>48h检出6.2%、污染占74.4%。结论阳性报警时间是鉴别分离菌株是否为污染菌的重要指标之一,临床医师需要结合血培养报阳时间、实验室指标、临床症状等进行综合判断,针对病原菌有效合理的使用抗菌药物,避免抗菌药物滥用。
Objective To investigate the significance of blood culture in the period of positive climacteric infection in clinical identification of infectious bacteria and bacteria. Methods A total of 12 861 positive isolates from blood cultures were collected from Jan. to Aug. 2015 in the hospital for comprehensive analysis of reported positive time, laboratory data and clinical data, and 1 254 isolates were divided into three groups 892 strains and 362 strains of contaminated bacteria. Results Among the 1 300 isolates, Escherichia coli mainly accounted for 30.31%, followed by coagulase-negative Staphylococcus aureus (26.46%), which was higher than that of the infected bacteria group (P <0.05) , 47.1% were detected in blood culture at the time of 0 ~ 12h, and the pollution was 4.1%. Staphylococcus aureus, Streptococcus pneumoniae and Acinetobacter baumannii were all infected bacteria, accounting for 100% 31.7%, pollution accounted for 42.1%; 25 ~ 48h detected 15.0%, pollution accounted for 60.6%;> 48h detected 6.2%, pollution accounted for 74.4%. Conclusion The positive alarm time is one of the important indexes to identify whether the isolated strains are contaminated bacteria. Clinicians need to combine blood culture time to report the yang, laboratory indexes and clinical symptoms to make a comprehensive judgment. Effectively and reasonably use antimicrobial agents against pathogens and avoid antibacterial Drug abuse.