湖北地区1999～2004年儿科败血症病原菌变迁与耐药性分析  

An Analysis of the Changes in and Drug Resistance of the Pathogenic Bacteria Causing Septicemia in Pediatric Patients in the Hubei District from 1999 to 2004

作　　者：方红[1] 李秀云[1] 王宏伟[1] 孙自镛[2] 杜鹏超[2] 

机构地区：[1]华中科技大学同济医学院附属同济医院儿科,武汉430030 [2]华中科技大学同济医学院附属同济医院检验科,武汉430030

出　　处：《医药导报》2006年第12期1323-1325,共3页Herald of Medicine

摘　　要：目的 了解湖北地区儿科败血症患儿近6a病原菌变迁及近2a常见细菌的耐药性。方法 收集1999年1月-2004年12月湖北地区15所三级甲等医院儿科败血症患儿血培养阳性菌，用Kirby-Bauer方法药敏实验的抑菌圈直径输入计算机，采用“WHONET-5”软件进行统计分析，根据美国国家临床实验室标准委员会（NCCLS）2002年标准判定耐药性。结果 革兰阳性菌检出构成比明显高于革兰阴性菌。表皮葡萄球菌6a间逐年增加，1999年检出构成比为22.7％，至2004年达38．8％，金黄色葡萄球菌逐年下降，从1999年29，3％下降到2004年6．4％。葡萄球菌对青霉素的耐药率〉96，0％，对红霉素的耐药率〉62．0％；表皮葡萄球对苯唑西林菌耐药率迭79．9％，明显高于金黄色葡萄球菌（18．3％）；未发现耐万古霉素的葡萄球菌和链球菌。大肠埃希菌、肺炎克雷白杆菌及沙门菌对头孢哌酮／舒巴坦和亚胺培南均敏感，而对氨苄西林、第1代头孢菌素的耐药率多〉50．0％。结论 儿科血培养检出菌存在严重耐药，及时监测病原菌变化及耐药趋势对指导，临床用药至关重要。Objective To study the changes in pathogenic bacteria causing pediatric septicemiain in the recent 6 years and the drug resistance of common bacteria in the recent 2 years in the Hubei district. Methods 942 strains of bacteria isolated from the blood of pediatric patients suffering from septicemia and hospitalized in the 15 top-level hospitals of the Hubei district from January 1999 to December 2004 were subjected to culture and identification and those isolated from 2003 to 2004 were submitted to drug sensitivity test, The diameter of the bacterial inhibition zone in the drug sensitivity test described by Kirby-Bauer was introduced into the computer and statistically analyzed with the ＂ WHONET 5＂ software. Drug resistauce was judged according to the criteria of the year 2002 released by the National Committee on Chinical Labortory Standards（ NCCLS）. Results The detectable rate of gram-positive bacteria was significantly higher than that of gram-negative bacteria. An annual increase in the detectable rate of Staphylococcus epidermidis was demonstrated during the 6 years： it was 22.7% in 1999 and 38.8% in 2004. In contrast, there was a yearly decrease in the detectable rate of Staphycocaus aureus： it was 29.3% in 1999 and 6.4% in 2004. The rate of drug resistance of Staphylococeus aureus to penicillin was as high as more than 96.0% and higher than 62.0% to erythromycin. The rate of drug resistance of Staphylococcus epidermidis to oxacillin reached 79.9 % . which was significantly higher than that of Staphylococcus aureus （ 18. 3 % ） . No strains of Staphylococcus and Streptococeus were shown to be resistant to vancomycin. Klebsiella pneumoniae, Escherichia coli and Salmonella were sensitive to cefoperazone ,sulbactam sodium and imipenem, whereas the drug resistance rates of these antibiotics to ampicillin and the first generation cephalosporins were higher than 50.0%. Conclusion Drug resistance of pathogenic bacteria isolated from pediatric patients was shown to be a serious problem. Timely monito

关 键 词：败血症 耐药率 儿童 

分 类 号：R725[医药卫生—儿科] R969.3[医药卫生—临床医学]