| 摘要: |
| 目的：探讨儿童医院感染病原菌的临床分布特点及耐药现状，为临床用药提供指导，为医院感染控制提供循证依据。方法：对2014年7月1日至2015年6月30日住院患儿发生医院感染的病原菌分布特点及耐药情况进行回顾性分析。结果：临床科室送检的44 451份标本中，确认为医院感染的病原菌1 034株，其中革兰阴性菌693株（67.02 %），革兰阳性菌232株（22.44 %），真菌109株（10.54 %）。病原菌检出的标本依次为痰（526株）、静脉血（197株）、支气管灌洗液（62株）、尿（56株）、分泌物（50株）、穿刺液（49株）及便（36株）等。病原菌检出科室主要为新生儿科（198株）、血液肿瘤科（148株）、重症医学科（127株）、心胸外科（134株）、肾脏免疫科（63株）。多重耐药菌336株，以革兰阴性菌为主，分别为鲍曼不动杆菌（52株）、大肠埃希菌（50株）、肺炎克雷伯菌肺炎亚种（45株）、肺炎链球菌（33株）、金黄色葡萄球菌（25株）、铜绿假单胞菌（15株）等；主要的多重耐药菌对青霉素类、头孢菌素类耐药率高。结论：我院医院感染病原菌以革兰阴性菌为主，对常用的抗菌药物耐药率较高，感染部位以呼吸道、血流感染为主，感染对象主要是危重病人和免疫力低下患儿。提示医院感染管理科要有针对性监控重点部门，指导其减少易感因素，重视病原菌培养，合理使用抗菌药物，降低医院感染发生率。 |
| 关键词: 儿童 医院感染 病原菌 多重耐药菌 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2016.06.014 |
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| 基金项目: |
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| Survey and Analysis of 1,034 Strains of Nosocomial Infection Pathogens in Children’s Hospital |
| Yang Zuqun, Li Suirong, Wang Li, Dai Zhenyu, Jing Chunmei, Liu Xiao, Duan Wenting |
| (Children’s Hospital of Chongqing Medical University, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400014, China) |
| Abstract: |
| Objective: Investigate clinical distribution characteristics and drug resistance status of infectious pathogens in children’s hospital, provide guidance for clinical treatment and statistical basis for infection control. Methods: Launch a retrospective analysis about the distribution characteristics and drug resistance status of infectious pathogens of inpatients acquired nosocomial infections on record between Jul. 1st, 2014 and Jun.31st, 2015. Results: According to our data, there were 1,034 strains of pathogen extracted from these nosocomial infections in clinical departments were 44,451 specimens, in which 693 strains of gram-negative bacteria account for 67.02%, 232 strains of gram-positive bacteria account for 22.44%, 109 strains of fungus account for 10.54%. Categories of specimens were: phlegm (526 strains), venous blood (197 strains), catheter (62 strains), puncture fluid (49 strains), urine (56 strains), secretions (50 strains), excrement (36 strains), etc. These pathogens were mainly detected from neonatal ward (198 strains), hematological ward (148 strains), ICU (127 strains), cardio-thoracic surgery ward(134 strains), nephrology ward(63 strains). We found 336 strains of multiple resistant bacteria, most of them were gram-negative bacteria, such as Acinetobacter Baumannii (52 strains), Escherichia coli (50 strains), Klebsiella pneumoniae (45 strains), Streptococcus pneumoniae (33 strains), Staphylococcus aureus (25 strains), Pseudomonas aeruginosa (15 strains), etc. The drug resistance of these multiple resistant bacteria were mainly against penicillins and cephalosporins. Conclusion: Gram-negative bacteria were the most common infectious pathogens in children’s hopital, usually carried high drug resistance for common antibiotics. Critical patients and children with low immunity were proved to be the most susceptible population. With the results above, we suggest that hospital infection control section should set targeted monitoring on high risk departments based on data analysis, provide guidance for controlling risk factors, rationally manage the use of antibiotics according to the results of pathogens culture, reduce the incidence of hospital infection. |
| Key words: children, nosocomial infection, pathogenic bacteria, multiple resistant bacteria |
