儿童产超广谱β-内酰胺酶大肠埃希菌感染的临床特征及药敏分析  

Clinical characteristics of children's infection with Escherichia coil (ESBLs+) and the drug-resistance aralysis

作　　者：王莹[1] 韩锋[1,2] 胡红兵[1] 陆小霞[1] 胡艳[1] 方玉蓉[1] 

机构地区：[1]武汉市儿童医院,武汉430016 [2]湖北中医学院

出　　处：《华中医学杂志》2007年第2期110-112,共3页Central China Medical Journal

摘　　要：目的了解产超广谱β-内酰胺酶(ESBLs)大肠埃希菌在儿童中的感染情况及特点。方法对2004年因呼吸道感染住院的患儿采用一次性鼻导管深插气管负压吸取痰液,部分患儿采集咽拭子。结果共检出产ESBLs菌447株(来自于429例患儿),占大肠埃希菌的59.8%。429例均为3岁内婴幼儿,其中婴儿274例(63.9%);同时合并其他病原体感染244例(56.9%),以支原体、衣原体和合胞病毒为主;115例(26.8%)原有基础性疾病;临床多使用过三代头孢菌素,病程长;产ES-BLs大肠埃希菌对氨苄西林、哌拉西林、头孢唑林、头孢呋新、头孢噻肟耐药率分别为100%、99%、99%、99%、66%,含酶类阿莫西林/棒酸、头孢哌酮/舒巴坦、头孢他啶、头孢吡肟耐药率分别为10%、5%、8%、13%,亚胺培南100%敏感。结论产ES-BLs大肠埃希菌在小儿呼吸道感染中占重要地位,临床表现有其特点,一旦确诊首选碳青霉烯类抗生素。Objective To investigate the incidence and clinical characteristics of Eseheriehia coil （Ec,ESBLs ＋ ）infection in children. Methods The data of bacteria culture in sputum from 2004 were collected. Results There are 447 Ec（ESBLs ＋ ） strainhad been isolated from 429 cases（59. 8%） in this year. All of the cases were under 3 years old. There are 274 of them （63.9 %） were under 1 years old and 244 of them were found coincided with other pathogens. Mycoplasma, Chlamydia and respiratory syncytial virus were the three dominating pathogens; 115 of them（26. 8%） had foundational diseases. The clinical manifestation were much respiratory passage excretion, inefficiency in experiential therapy, applied the third generation cephalosporin and long course of disease; The drug-resistance rate to Ampicillin, Piperacillin, Cefazolin, Cefuroxime, Cefotaxime was100%,99%, 99%, 99%, 66% ; The drug-resistance rate to Ampxillin/elavalavie acid, Cefoperazone/sulba, Ceftazidime, Cefepime was 10%, 5 % ,8 %, 13 %;The drug-resistance rate to imipenem was 0. Conclusion Ee（ESBLs ＋ ） is an important bacteria pathogen in respiratory infection in children. Once make a definite diagnosis of Ec（ESBLs ＋ ） infection, the first choice is to select carbapenem antibiotics.

关 键 词：儿童 超广谱Β-内酰胺酶 大肠埃希菌 

分 类 号：R725.1[医药卫生—儿科]