成都市儿童医院重症监护病房2002～2006年病原菌流行分布与耐药趋势分析  

Analysis of epidemic distribution and drug resistance of the clinically-isolated bacteria in intensive care unit of Chengdu Children's Hospital from 2002 to 2006

作　　者：张国英[1] 魏艳[1] 王晓蕾[1] 张励[1] 郑静[1] 黄成[1] 廖霓[1] 

机构地区：[1]成都市儿童医院ICU,610017

出　　处：《中国小儿急救医学》2007年第4期313-316,342,共5页Chinese Pediatric Emergency Medicine

基　　金：2005年度四川省学术和技术带头人培养资金(重点项目)资助课题(编号:2005-1)

摘　　要：目的探讨ICU病原菌分布和耐药趋势的变化规律。方法对成都市儿童医院2002～2006年ICU住院患儿的所有分离菌株进行分析,检测方法严格按照美国国家临床试验室标准委员会(NCCLS)最新标准进行。结果2002～2006年成都市儿童医院ICU患儿各类标本共分离出病原菌352株,其中革兰阴性菌61.9%、革兰阳性菌33.8%、真菌4.3%。本组病原菌前10位依次为大肠埃希杆菌(22.2%)、肺炎克雷白杆菌(12.5%)、金黄色葡萄球菌(9.7%)、表皮葡萄球菌(8.8%)、阴沟肠杆菌(8.5%)、其他葡萄球菌(7.4%)、铜绿假单胞菌(7.1%)、鲍曼不动杆菌(4.6%)、肠球菌属(4.3%)、化脓性链球菌(3.7%)。痰培养和血培养病原菌排序不同。结论2005～2006年与2002～2004年相比,本院ICU常见病原菌耐药趋势呈多态性变化。及时监测ICU病原菌耐药趋势变化对指导危重患儿合理用药致关重要。Objective To investigate the epidemic distribution and drug resistance pattern of pathogenic bacteria in Pediatric Intensive Care Unit （PICU） of Chengdu Children＇s Hospital. Methods All the bacteria isolated from 2002 to 2006 were analyzed. Tests were performed according to the guidelines of NCCLS. Results Gram negative bacteria accounted for 61.93 %, while Gram positive bacteria and fungi accounted for 33.8 % and 4.3 % respectively in 352 isolated strains. The top ten pathogenic bacteria in PICU were Escherichia coli （22.2 % ）, KlebsieUa pneumoniae （ 12.5 % ）, Staphylococcus aureus （ 9.7 % ）, Staphylococcus epidermidis （8.8 % ）, Enterobacter cloacae （ 8.5 % ）, Other Staphylococcus （ 7.4 % ）, Pseudomonas aeruginosa （7.1% ）, Acinetobacter baumannii（4.6 % ）, Enteococcus（4.3 % ） and Streptococcus pyogenes（3.7 % ）. The order of top ten pathogens was different between that in lower respiratory tract infection and that in blood specimen. Conelusion The trend of antibiotics resistance of pathogenic bacteria in PICU of Chengdu Children＇s Hospital was changing in recent two years compared with the past three years. Timely monitoring of the drug resistance trend in PICU is very important for making a reasonable guideline of clinical therapy.

关 键 词：儿科 重症监护病房 病原菌 耐药 抗生素 

分 类 号：R446.5[医药卫生—诊断学]