儿童患者血培养分离菌的分布与耐药性

发布时间：2018-06-08 05:42

本文选题：血培养 + 儿童　；参考：《中国感染与化疗杂志》2016年05期

【摘要】：目的了解湖北省襄阳市中医医院儿童患者血培养分离菌的临床分布和耐药状况,为儿科医师诊治提供依据。方法收集2014年度门诊及住院儿科患者血培养的分离菌及药敏试验进行回顾性分析。结果儿童患者血培养共分离细菌257株,其中以凝固酶阴性葡萄球菌为主,占31.5%;其次是大肠埃希菌(占18.3%),肺炎克雷伯菌(占15.2%),金黄色葡萄球菌(金葡菌,占11.3%),肠球菌(占9.7%)等。金葡菌和凝固酶阴性葡萄球菌对青霉素、苯唑西林、头孢菌素、红霉素、克林霉素耐药率相对较高,对利福平、阿米卡星的耐药率相对较低;肠球菌属对红霉素和环丙沙星耐药率较高,对青霉素和氨苄西林耐药率较低。尚未发现耐万古霉素、替考拉宁或利奈唑胺的革兰阳性球菌。MRSA的检出率为27.6%,MRCNS检出率为53.1%。大肠埃希菌和肺炎克雷伯菌对氨苄西林、头孢唑林耐药率较高,对头孢哌酮-舒巴坦、哌拉西林-他唑巴坦耐药率较低,ESBL阳性的大肠埃希菌和肺炎克雷伯菌检出率分别为31.9%和23.1%。结论凝固酶阴性葡萄球菌为医院儿童患者血培养主要分离菌。应加强对儿童患者血培养中的分离菌进行耐药性监测,掌握其耐药特点以便有效地控制和防止多重耐药现象的发生。
[Abstract]:Objective to investigate the clinical distribution and drug resistance of blood isolated bacteria from children in Xiangyang traditional Chinese Medicine Hospital, Hubei Province, and to provide evidence for pediatrician diagnosis and treatment. Methods the isolated bacteria and drug sensitivity test of blood culture of outpatient and inpatient pediatric patients in 2014 were analyzed retrospectively. Results 257 strains of bacteria were isolated in blood culture of children, among which coagulase negative staphylococcus was the main bacteria (31.5%), Escherichia coli (18.3N), Klebsiella pneumoniae (15.2C), Staphylococcus aureus (11.3g), Enterococcus (9.7B) and so on. The resistance rates of Staphylococcus aureus and coagulase-negative staphylococcus to penicillin, oxacillin, cephalosporin, erythromycin and clindamycin were higher than those of rifampicin and amikacin. Enterococcus has higher resistance to erythromycin and ciprofloxacin and lower resistance to penicillin and ampicillin. No vancomycin-resistant, teicoplanin or linazolamide Gram-positive cocci were detected. The positive rate of MRSA was 27.6% and the positive rate of MRCNS was 53.1%. The resistance rates of Escherichia coli and Klebsiella pneumoniae to ampicillin and cefazolin were higher than those of cefoperazone-sulbactam and piperacillin tazobactam. The positive rates of Escherichia coli and Klebsiella pneumoniae were 31. 9% and 23. 1% respectively. Conclusion Coagulase negative staphylococcus is the main isolated bacteria in blood culture of children in hospital. In order to effectively control and prevent the occurrence of multidrug resistance, we should strengthen the monitoring of drug resistance of isolated bacteria in blood culture of children patients and master the characteristics of drug resistance.
【作者单位】：湖北中医药大学附属医院襄阳市中医医院检验科;
【分类号】：R446.5

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