儿科病房分离菌株分布情况及耐药性分析

Distribution of strains isolated from department of pediatrics and their drug-resistance

  • 摘要: 目的 回顾性研究我院儿科感染性疾病病原菌的分布及耐药情况,为临床合理应用抗生素提供依据。 方法 收集2011年6月-2012年6月儿科住院病人痰液、尿液等标本进行培养、菌种鉴定及最低抑菌浓度测定。 结果 共计522例标本分离菌株231株,阳性检出率为44.3%。革兰阴性杆菌占55.8%(129/231),最常见依次为肺炎克雷伯菌37.9%(49/129)、大肠埃希菌30.2%(39/129)、阴沟肠杆菌16.3%(21/129);革兰阳性球菌占36.8%(85/231),其中金黄色葡萄球菌占74.1%(63/85)、凝固酶阴性的葡萄球菌占15.3%(13/85);真菌占7.36%(17/231),其中白色假丝酵母菌占82.3%(14/17)。产超广谱β-内酰胺酶(ESβLs)的大肠埃希菌、肺炎克雷伯菌、肠杆菌属检出率分别为66.7%(26/39)、24.5%(12/49)、11.5%(3/26),耐甲氧西林金黄色葡萄球菌(methicillin-resistant staphylococcu saureus,MRSA)和耐甲氧西林凝固酶阴性葡萄球菌(methicillin resistant coagulase-negative staphylococci,MRCNS)检出率分别为31.7%(20/63)和76.9%(10/13),未检出耐万古霉素肠球菌(vancomycinresistant enterococci,VRE)、耐万古霉素金黄色葡萄球菌(vancomycin resistant staphylococcu saureus,VRSA)。革兰阴性细菌对碳青霉烯类、氨基糖苷类、哌拉西林/他唑巴坦敏感度较高,而对氨苄西林、哌拉西林、头孢菌素等敏感率相对偏低,尤以大肠埃希菌和肺炎克雷伯菌为著。葡萄球菌属对青霉素、大环内酯类敏感度较低,对于万古霉素、链阳性菌素类、恶唑酮类等抗生素尚未检出不敏感菌株。我院儿科院内感染率为1.88%,3例院内感染菌均为多重耐药菌。 结论 儿科病房以ESβLs肠杆菌科细菌、MRSA及MRCNS为主要耐药菌。

     

    Abstract: Objective To retrospectively analyze the distribution of strains isolated from department of pediatrics and their drug resistance in order to provide the evidence for rational use of antibiotics. Methods Sputum and urine samples, collected from patients admitted to department of pediatrics in our hospital from June 2011 to June 2012, were cultured. Strains were identified and the minimum bacteria-inhibiting level of antibiotics was measured. Results A total of 231 strains were isolated from 522 samples with a positive detection rate of 44.3%. Of the detected 129(55.8%) Gram-negative bacilli, Klebsiella pneumoniae, Escherichia coli and Enterobacter cloacae accounted for 37.9% (49/129), 30.2% (39/129), and 16.3% (21/129), respectively. Of the detected 85(36.8%) Gram-positive strains, Staphylococcus aureus, coagulase- negative staphylococci and fungi accounted for 74.1% (63/85), 15.3% (13/85), and 7.36% (17/231) respectively. Of the detected 17 fungi, Candida albicans accounted for 82.3% (14/17). The ESβL–releasing Escherichia coli, Klebsiella pneumoniae and Enterobacter cloacae accounted for 66.7% (26/39), 24.5% (12/49) and 11.5% (3/26), respectively. The methicillin- resistant Staphylococcu saureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) accounted for 31.7% (20/63) and 76.9% (10/13), respectively. No vancomycin- resistant Enterococci (VRE)and vancomycin- resistant Staphylococcu saureus (VRSA) were detected. Gram-negative bacteria, especially Escherichia coli and Klebsiella pneumoniae, were highly sensitive to carbapenems, aminoglycoside and piperacillin/tazobactam while lowly sensitive to ampicillin, piperacillin and cephalosporin. Staphylococcus was lowly sensitive to penicillin and macrolide. All the strains were sensitive to vancomycin, streptogramins and oxazolidine. The nosocomial infection rate in department of pediatric of our hospital was 1.88% and the 3 nosocomial infection strains were multi drug-resistant. Conclusion Respiratory infection is the dominant disease in department of pediatrics. The major drug-resistant bacteria are ESβL –releasing Enterobacteriaceae, MRSA, and MRCNS. The result of the study is of certain significance for the rational use of antibiotics.

     

/

返回文章
返回