儿童与成人血培养病原菌分布及耐药性比较  

Comparison of bacteria distribution and drug resistance between pediatric patients and adult patients for bacteria isolated from blood culture

作　　者：张金锋[1] 方晔[2] 

机构地区：[1]浙江省义乌市中心医院,浙江义乌322000 [2]浙江省义乌市疾病预防控制中心,浙江义乌322000

出　　处：《中国卫生检验杂志》2009年第11期2632-2634,共3页Chinese Journal of Health Laboratory Technology

摘　　要：目的：探讨儿童与成人血液感染的病原学特点及细菌耐药之间的差异。方法：收集2004年1月-2007年12月四年间从临床住院患儿及成人患者的血液细菌培养标本,VITEK-AMS微生物鉴定仪进行病原菌鉴定和药敏试验。结果：从儿童所送检的标本中检出致病菌678株,以革兰阳性菌为主,共501株（73.89%）,以葡萄球菌最为常见。成人患者中共检出617株病原菌,以革兰阴性菌为主,共396株（64.18%）,以沙门菌属为常见。两组间,除金黄色葡萄球菌、嗜麦芽窄食单胞菌等构成比差异无统计学意义以外,其余构成比差异均有统计学意义。药敏显示两组间金黄色葡萄球菌的药敏差异无统计学意义,均对万古霉素全部敏感,对青霉素的耐药率均较高。儿童组和成人组的大肠埃希菌及肺炎克雷伯菌均对亚胺培南最敏感,其次为阿米卡星,对其它抗生素的耐药均较高。其中儿童组肺炎克雷伯菌的产超广谱β-内酰胺酶（ESBLs）率为84.6%,明显高于成人组的产ESBLs率13.6%（2χ=34.01,P〈0.01）,而对除β-内酰胺类以外抗生素的耐药差异无统计学意义。结论：儿童与成人血液感染的病原菌的分布差异很大,要根据儿童与成人血液感染的病原菌的分布特点,依据药敏结果选用有效抗生素。Objective：To analyze the difference of bacteria distribution and drug resistance of pediatric patients and adult patients for bacteria isolated from blood.Methods：The positive in blood culture of pediatric patients and adult patients were analyzed in our hospital from Jan 2004 to Dec 2007.VITEK-AMS were used to identify the pathogenic bacteria and conduct drug resistance test.Results：Total 678 strains of bacteria from pediatric patients was isolated.The isolating rate of Gram-positive bacteri was the highest（501 strains,73.89%）.Staphylococcus was is one of the main pathogens.Total 617 strains of bacteria from audlt patients was isolated.The isolating rate of gram-negative bacteria was the highest（396 strains,64.18%）.Among gram-negative bacteria,Salmonella spp was in the first place.Composition ratios of other bacteria of two groups were different markedly.Vancomycin was the highest susceptible to Staphylococcus aureus.The most sensitive antibiotic to E.coli and K.pneumoniae was imipenem,followed by amikacin.E.coli and K.pneumoniae were commonly resistant to the other antibiotics.The isolating rate of K.pneumoniae with extended-spectrum beta-lactamases strains（ESBLs） from pediatric patients was 84.6%,was higher than which isolated from audlt patients13.6%（χ2=34.01,P0.01）.Conclusions：Composition ratios of bacteria of pediatric patients and adult patients are different obviously.The identification of bacteria and drug sensitive test are helpful to clinical therapy.

关 键 词：血培养 耐药性 

分 类 号：R446.5[医药卫生—诊断学]