|
|
| |
|
|
| 本文已被：浏览 716次 下载 294次 |
码上扫一扫！ |
| 2018-2021 年儿童血流感染病原菌分布及耐药性分析 |
| 刘明雷,姚玲,李小超,高春燕 |
|
|
| ((唐山市妇幼保健院,唐山市发育异常与相关疾病分子医学重点实验室,河北唐山 063000)) |
|
| 摘要: |
| 目的:分析某院2018-2021 年儿童血流感染病原菌分布及耐药性,为儿科抗菌药物的合理应用提供参考。方法:回顾性
分析2018-2021 年唐山市妇幼保健院住院患儿的血培养标本,探讨病原菌分布及药物敏感性特征。结果:29 250 份血培养标本
共检出阳性菌株702 例,阳性率为2. 40%。革兰阴性菌占比54. 99%(386/ 702),其中最多的为大肠埃希菌19. 37%(136/ 702),
其次为肺炎克雷伯菌14. 81%(104/ 702);革兰阳性菌占比44. 73%(314/ 702),其中最多的为肺炎链球菌16. 38%(115/ 702),其
次表皮性葡萄球菌10. 11%(71/ 702)。386 株革兰阴性菌中,大肠埃希菌对氨苄西林、头孢唑林、头孢呋辛、复方磺胺甲唑、四
环素和头孢噻肟的耐药率较高,分别为88. 97%、84. 56%、66. 91%、66. 18%、63. 97%和62. 50%,对多黏菌素B 敏感;肺炎克雷伯
菌对头孢唑林、氨苄西林/ 舒巴坦、头孢呋辛、莫西沙星、哌拉西林和头孢噻肟的耐药率较高,分别为81. 73%、61. 54%、61. 54%、
54. 81%、53. 85%和51. 92%,对多黏菌素B 敏感。314 株革兰阳性菌中,肺炎链球菌对红霉素、克林霉素和四环素的耐药率较
高,分别为97. 39%、95. 65%和88. 70%,对左氧氟沙星、莫西沙星、利奈唑胺、万古霉素、替考拉宁和泰利霉素均敏感;凝固酶阴
性葡萄球菌对青霉素、红霉素和苯唑西林的耐药率较高,分别为90. 99%、81. 98%和72. 07%,对利奈唑胺、万古霉素和替考拉宁
均敏感。结论:我院血流感染病原菌种类繁多,以大肠埃希菌和肺炎链球菌为主,耐药形势严峻,对革兰阴性菌引起的感染推荐
经验治疗药物为头孢他啶或头孢吡肟,对革兰阳性菌引起的感染推荐经验治疗药物为万古霉素、替考拉宁或利奈唑胺。 |
| 关键词: 儿童 血流感染 病原菌 耐药性 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.01.010 |
|
| 基金项目:国家科技基础资源调查专项项目,编号2019FY101200;河北省2023 年度医学科学研究课题计划项目,编号20231759。 |
|
| Distribution and Drug Resistance of Pathogenic Bacteria in Bloodstream Infections in Children from 2018 to 2021 |
| Liu Minglei, Yao Ling, Li Xiaochao, Gao Chunyan |
| ((Tangshan Maternal and Child Health Hospital, Key Laboratory of Molecular
Medicine for Abnormal Development and Related Diseases in Tangshan, Hebei Tangshan 063000, China)) |
| Abstract: |
| Objective: To analyze the distribution and drug resistance of pathogenic bacteria in bloodstream infections in children of a
hospital from 2018 to 2021, so as to provide reference for rational application of antibiotics in pediatrics. Methods: Blood culture
samples of hospitalized children were retrospectively studied in Tangshan Maternal and Child Health Hospital from 2018 to 2021. The
distribution and drug sensitivity of pathogenic bacteria were analyzed. Results: A total of 702 positive strains were detected in 29,250
blood culture samples, with a positive rate of 2. 40%. The proportion of Gram-negative bacteria was 54. 99% (386/ 702), of which
Escherichia coli took the lead, totally 19. 37% (136/ 702), followed by Klebsiella pneumoniae of 14. 81% (104/ 702). The proportion of
Gram-positive bacteria was 44. 73% ( 314/ 702), of which Streptococcus pneumoniae was 16. 38% ( 115/ 702 ), followed by
Staphylococcus epidermidis of 10. 11% (71/ 702). Among 386 Gram-negative strains, the resistance rates of E. coli to ampicillin,
cefazolin, cefuroxime, cotrimoxazole, tetracycline and cefotaxime were respectively 88. 97%, 84. 56%, 66. 91%, 66. 18%, 63. 97%
and 62. 50%, and were sensitive to polymyxin B. The resistance rates of K. pneumoniae to cefzolin, ampicillin/ sulbactam, cefuroxime,
moxifloxacin, piperacillin and cefotaxime were respectively 81. 73%, 61. 54%, 61. 54%, 54. 81%, 53. 85% and 51. 92%, and were
sensitive to polymyxin B. Among 314 Gram-positive strains, S. pneumoniae had high resistance rates to erythromycin, clindamycin and
tetracycline, which were respectively 97. 39%, 95. 65% and 88. 70%, and were sensitive to levofloxacin, moxifloxacin, linezolid,
vancomycin, teicolanin and telycin. The resistance rates of coagulase negative Staphylococcus to penicillin G, erythromycin and
benzacillin were respectively 90. 99%, 81. 98% and 72. 07%, and were sensitive to linezolid, vancomycin and teicolanin. Conclusion:
The pathogens of bloodstream infections in our hospital are complex, mainly E. coli and S. pneumoniae, and the drug resistance is
severe. For infections induced by Gram-negative bacteria, ceftazidime or cefepime are recommended as the first selection for empirical
treatment, for infections induced by Gram-positive bacteria, vancomycin, teicolanin or linezolid are recommended as the first selection
for empirical treatment. |
| Key words: children bloodstream infections pathogens drug resistance |
|
|
|
|
|
