中文摘要：

目的分析血培养阳性病原菌的耐药情况及其临床科室分布特点,指导临床合理用药。方法对武汉中心医院2012~2014年送检的11 275套血培养标本结果进行回顾性分析。培养仪为美国赛默飞世尔科技VersaTREK微生物培养仪;微生物鉴定和药敏分析为美国BD-PHOENIX全自动微生物鉴定/药敏系统。结果 11 275套血培养标本中共检出病原菌636株,前4位依次为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌和屎肠球菌。检出1株耐万古霉素的屎肠球菌和1株泛耐药的肺炎克雷伯菌。病原菌临床科室分布排序前3位为消化内科、肾内科和重症医学科（ICU）,ICU没有明显优势病原菌。结论血培养阳性病原菌在临床科室的分布情况不同,病原菌的鉴定和药物敏感性结果的及时准确报告,可减少广谱抗生素的使用,指导临床抗生素降阶梯疗法的应用。

英文摘要：

Objective To analyze drug resistance of pathogenic bacteria from the blood culture and distribution in clinical departments,and to guide the rational clinical drug use.Methods We retrospectively analyzed 11 275 samples of blood cultures in The Central Hospital of Wuhan from 2012 to 2014.The blood specimens were cultured by VersaTREK（USA）.The pathogenic bacteria were identified and their drug resistance was analyzed by BD-PHOENIX 100 automicrobiological identification systems（USA）.Results Among the 11 275 blood cultures,636 bacterial strains were detected.The top four bacterial strains were Escherichia coli,Staphylococcus aureus,Klebsiella pneumonia and Enterococcus faecium.A vancomycin-resistant Enterococcus faecium strain and a pandrug-resistant Klebsiella pneumoniae strain were detected.The top three clinical departments with distribution of pathogens were Gastroenterology Department,Nephrology Department and Intensive Care Unit（ICU）.Pathogens isolated from ICU were evenly distributed.Conclusion Distributions of pathogenic bacteria in the blood culture are different in clinical departments.Identification of pathogenic bacteria and result of drug susceptibility can reduce use of broadspectrum antimicrobials and enhance antimicrobial de-escalation.