| 摘要: |
| 目的：了解我院儿科病区的病原菌分布及耐药情况，为抗菌药物的合理使用提供依据。方法：对2013年10月至2015年5月我院儿科病区分离的病原菌及其耐药性进行回顾性分析与总结。结果：1 564份标本共检出病原菌327株，阳性率为20.9%；其中革兰阳性菌占52.6%，革兰阴性菌占44.3%，真菌占3.1%。排名前5位的病原菌依次为肺炎链球菌（25.4%）、金黄色葡萄球菌（16.5%）、大肠埃希菌（14.7%）、肺炎克雷伯菌（8.6%）和流感嗜血杆菌（6.1%）。革兰阳性菌对红霉素和青霉素的耐药率较高，其中肺炎链球菌对红霉素和青霉素的耐药率分别为95.5%和62.1%；革兰阴性菌对第三、四代头孢菌素、单环β-内酰胺类、碳青霉烯类等的耐药率较低，其中大肠埃希菌和肺炎克雷伯菌对头孢他啶的耐药率分别为8.8%和25.0%。多重耐药肺炎链球菌、表皮葡萄球菌、阴沟肠杆菌的检出率分别为45.6%、87.5%和35.7%，耐甲氧西林金黄色葡萄球菌（MRSA）的检出率为18.4%，产超广谱β内酰胺酶（ESBLs）大肠埃希菌和肺炎克雷伯菌的检出率为53.5%和38.5%。结论：我院儿科病区以革兰阳性球菌感染为主，多重耐药肺炎链球菌的检出率较高，应加强抗菌药物合理使用的监管，减少耐药菌株的产生。 |
| 关键词: 儿科 病原菌 耐药性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.03.015 |
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| 基金项目: |
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| Distribution and Drug Resistance of Pathogenic Bacteria in Pediatric Department |
| Chen Xiaoying, Zhang Yan, Tang Xiaofei, Long Yandan |
| (Fengdu People’s Hospital of Chongqing, Chongqing 408299, China) |
| Abstract: |
| Objective: To investigate the distribution and antimicrobial resistance of pathogens isolated from the pediatric department for reference of clinical rational use of antibiotics. Methods: The pathogens isolated from the pediatric department's specimens during October 2013 to May 2015 and their distribution and antimicrobial resistance were analyzed statistically. Results: A total of 327 strains of pathogens were isolated from the pediatric department, of which, gram-positive strains’ rate was 52.6%, gram-negative strains’ rate was 44.3%, fungus’ rate was 3.1%. The rate of Streptococcus pneumonia, Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia and Hemophilus influenza was 25.4%, 16.5%, 14.7%, 8.6% and 6.1%, respectively. The drug resistant rate of gram-positive bacteria to erythromycin and penicillin was higher, such as, the drug resistant rate of Streptococcus pneumonia was 95.5% and 62.1%. It was lower that the drug resistant rate of gram-negative bacteria to the third and fourth generation cephalosporins, monocyclic β-lactam, and carbapenems, etc. The drug resistant rate of Escherichia coli and klebsiella pneumoniae to ceftazidime was 8.8% and 25.0%. The detection rate of multiple drug resistant Streptococcus pneumonia, staphylococcus epidermidis and enterobacter cloacae was 45.6%, 87.5% and 35.7%, respectively. The detection rate of methicillin resistant Staphylococcus aureus (MRSA) was 18.14%, and the extended-spectrum β-lactamases (ESBLs)-producing Escherichia coli and klebsiella pneumoniae was 53.5% and 38.5%. Conclusion: Gram-positive strains took the lead in the pediatric department, and the detection rate of multiple drug resistant Streptococcus pneumonia was rising. Thus it was important to strengthen the management of antibiotics' rational use, and reduce the generation of drug-resistant strains. |
| Key words: Pediatric Pathogens Drug-resistance |
