长沙市某医院儿科常见病原菌分布及其耐药性分析  

Analysis on Distribution and Drug Resistance of Common Pathogenic Bacteria in Pediatrics Department of a Hospital in Changsha

作　　者：李艳冰[1] 高骞[1] 刘文恩[1] 邹明祥[1] 陈振华[1] 简子娟[1] 

机构地区：[1]中南大学湘雅医院检验科,湖南长沙410008

出　　处：《实用预防医学》2011年第2期208-210,共3页Practical Preventive Medicine

基　　金：湖南省科技厅课题(08FJ3175)

摘　　要：目的了解和探讨某医院儿科分离的病原菌构成及其耐药情况,为临床诊治提供实验室依据。方法 对2009年1-12月该院儿科2 973份临床标本进行接种培养、分离,利用VITEK2全自动细菌鉴定仪对病原菌进行鉴定和药敏试验,对所得结果进行回顾性分析。结果2973份标本中共分离出常见病原菌405株,分离率为13.6%,病原菌主要分离自痰和血液标本;所分离出的405株菌株中革兰阳性球菌占31.6%,以凝固酶阴性葡萄球菌(CONS)为主达48.4%,MRSA和MRCNS检出率分别为45.5%和54.8%,未发现耐万古霉素菌株;革兰阴性杆菌占60.5%,排在前4位的是大肠埃希菌、肺炎克雷伯杆菌、鲍曼不动杆菌和铜绿假单胞菌,大肠埃希菌和肺炎克雷伯杆菌对氨苄西林的耐药率都高于95%,对头孢曲松及头孢呋辛等耐药率高于50%,未发现亚胺培南耐药株。结论该院儿科分离的病原菌存在严重耐药现象,耐甲氧西林葡萄球菌(MRS)检出率高,大肠埃希菌和肺炎克雷伯杆菌对多种抗菌药物耐药率高,加强耐药监测,合理使用抗生素非常重要。Objective To investigate the distribution and drug resistance of the pathogenic bacteria isolated from Department of Pediatrics,Xiangya Hospital,and to provide the laboratory evidence for clinical diagnosis and treatment. Methods Pathogenic bacteria were isolated from 2,973 clinical specimens which collected from the patients in Pediatrics Department,Xiangya Hospital from January to December,2009.The bacteria identification and the drug sensitive test were performed by VITEK2 automated identification system.The results were retrospectively analyzed. Results Totally 405 strains of common pathogenic bacteria were isolated from 2,973 specimens,with the positive rate of 13.6%.Most of the pathogenic bacteria were isolated from respiratory specimens and blood samples.Among the 405 isolated strains,31.6% of them were gram-positive cocci.Most of gram-positive cocci were coagulase-negative staphylococci（CONS）,accounting for 48.4%.The detection rates of methicillin-resistant Staphylococcus aureus（MRSA） and methicillinresistant coagulase-negative staphylococci（MRCNS） were 45.5% and 54.8%,respectively.No vancomycin-resistant strains were found.Among the 405 isolated strains,60.5% of them were gram-negative bacilli.The top four of gram-negative bacilli were Escherichia coli,Klebsiella pneumoniae,Acinetobacter baumanii and Pseudomonas aeruginosa.The antibiotic resistance rates of Escherichia coli and Klebsiella pneumoniae to ampicillin were both higher than 95%,and those to ceftriaxone and cefuroxime were higher than 50%.No imipenem-resistant strains were found. Conclusions The pathogens isolated from Department of Pediatrics,Xiangya Hospital are seriously resistant to common antibiotics.The proportion of MRS in staphylococci is high.Escherichia coli and Klebsiella pneumoniae strains show high resistant to many antibiotics.Great importance should be attached to strengthening the surveillance of drug resistance and using antibiotics reasonably.

关 键 词：儿科 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]