目的: 研究内蒙古自治区人民医院2012－01－01 ～ 2015－10－30 血流感染病原菌的分布及耐药状况，
为临床治疗血流感染提供参考依据。方法: 采用MIC 法测定抗菌药物的敏感性，应用WHONET 5．6软件，对我院
2012－01－01～ 2015－10－30 血培养分离的病原菌进行分析。结果: 共分离病原菌911 株，包括革兰氏阳性菌406
株( 44．5%) 、革兰氏阴性菌427 株( 46．9%) 、念珠菌属25 株( 2．7%) 和其他菌属53 株( 5．9%) ，分离出的大肠埃希
菌最多，共261 株( 28．7%) ，其次是人葡萄球菌人亚种201 株( 22．1%) 以及克雷伯菌76 株( 8．4%) 和金黄色葡萄
球菌54( 5．9%) 和肠球菌属53 株( 5．8%) ; 笨唑西林耐药的金黄色葡萄球菌和笨唑西林耐药的凝固酶阴性葡萄
球菌它们的分离率分别是45．4%和74．3%，没有发现对万古霉素抗菌药物耐药的金黄色葡萄球菌以及凝固酶阴
性的葡萄球菌; 屎肠球菌和粪肠球菌中分别有1．5%和2．8%对万古霉素耐药; 大肠埃希菌和肺炎克雷伯菌ESBLs
的阳性率分别为42．8%和36．6%，对氨苄西林的耐药率分别是86．7%和83．4%; 大肠埃希菌对喹诺酮类抗菌药物的
耐药率在64%以上。结论: 我院血流感染细菌是以大肠埃希菌、葡萄球菌属和克雷伯菌属最为多见; 对头孢类和
喹诺酮类抗菌药物的耐药率明显较高，临床应该参照药敏报告结果合理地选择抗菌药物。

Objective: To provide reference data for clinical treatment of bacterial blood infection
through investigating the distribution and antimicrobial susceptibility profiles of pathogenic bacteria isolated
from blood samples from the inpatients hospitalized between January 1，2012 and October 30，
2015．Methods: MIC method was used to test the antimicrobial susceptibility of the bacterial isolates
and WHONET 5．6 version software was used to analyze the isolates from blood samples of the inpatients
between January 1， 2012 and October 30，2015．Results: A total of 911 isolates were separated during
this study，which were composed of 406 isolates of gram positive bacteria( 44．5%) ， 427 isolates of gram
negative bacteria( 46．9%) and 25 isolates of candida species( 2．7%) ．Among these isolates， the most i-
solated bacteria was E． coli ( 261，28．7%) ，followed by Staphylococcus aureus subspecies ( 201，22．1%) ，
Klebsiella spp( 76，8．4%) ， staphylococcus aureus( 54，5．9%) and Enterococcus species( 53，5．8%) ．
The isolation rate of oxacillin resistant staphylococcus aureus and negative staphylococci were
45．4%and 74．3%．No vancomycin resistant staphylococcus aureus strains was isolated．The vancomycin
resistance rates of Enterococcus faecium and Enterococcus faecalis were 2．8%and 1．5%， respectively．
ESBLs positive rates for E．coli and klebsiella pneumoniae were 42．8%and 36．6%， respectively．The resistance
rate of E．coli and klebsiella pneumoniae isolates to ampicillin were 86．7%and 83．4%， respectively．
The resistance rate of E．coli to fluoroquinolones was higher than 64%．Conclusion: The most isolated
bacterial pathogens separated from blood samples were E．coli， staphylococci and Klebsiella spp．
The resistance rates to cephalosporins and fluoroquinolones were significantly higher．Rational antimicrobials
should be selected based on the drug susceptibility test report on clinic．

R372

 收稿日期: 2016－01－18; 修回日期: 2016－04－09
基金项目: 内蒙古自治区卫生厅医疗卫生科研计划项目( 2010102)
作者简介: 燕成岭( 1962－) ，男，内蒙古自治区人民医院检验科主任检验师。
通讯作者: 韩艳秋，主任医师，教授，医学博士，硕士研究生导师，E－mail: qyh1016@ sina．com 内蒙古医科大学附属医院
检验科， 010050