526例儿童生殖道分泌物细菌培养及耐药性分析  

Analysis of Bacterial Culture of Genital Tract Secretions and Drug Resistance of 526 Children

作　　者：周颖[1] 徐樨巍[1] 宋文琪[1] 

机构地区：[1]首都医科大学附属北京儿童医院检验科,北京100045

出　　处：《现代检验医学杂志》2011年第2期95-98,100,共5页Journal of Modern Laboratory Medicine

摘　　要：目的 回顾性分析2009年1月～12月北京儿童医院门诊及住院患儿526例生殖道分泌物细菌培养中病原菌的检出率、分布及耐药性分析,为临床提供疾病的诊断依据,通过了解生殖道分泌物细菌对抗生素的耐药变化,合理选择抗生素以提高疗效.方法 对2009年1月～12月北京儿童医院门诊及住院患儿526例生殖道分泌物进行细菌分离培养、鉴定和药敏试验,并对结果进行分析.结果 526例儿童生殖道分泌物中除50例无菌生长外共检出细菌476株,占90.5%（476/526）.其中革兰阳性杆菌106株,占22.3%（106/476）,凝固酶阴性葡萄球菌87株,占18.3%（87/476）,有致病意义的病原菌检出283株,占59.5%（283/476）.其中革兰阳性球菌82株17.2%（82/476）,革兰阴性杆菌173株,占36.3%（173/476）,奈瑟氏菌属12株,其中淋病奈瑟氏菌10株,占2.1%（10/476）,真菌16株,占3.4%（16/476）.金黄色葡萄球菌对青霉素G100%耐药,对阿奇霉素、红霉素的耐药率达68.8%,对克林霉素的耐药率也达31.2%;化脓性链球菌对红霉素、克林霉素的耐药率最高达84.6%;肺炎链球菌对红霉素、克林霉素、四环素的耐药率最高达100%,对青霉素G的耐药率也达10%,中介率为30%,对头孢噻肟、头孢吡肟的耐药率达10%和20%;流感嗜血杆菌11.6%可产生β-内酰胺酶,对β-内酰胺酶类抗生素耐药.对复方新诺明的耐药率达46.5%;淋病奈瑟菌50%可产生β-内酰胺酶,对环丙沙星耐药率最高达80%,对青霉素G的耐药率已达50%,中介敏感率达40%,对头孢吡肟、头孢呋辛酯耐药少见为10%.结论 526例儿童生殖道分泌物细菌培养中致病细菌种类较多,女童细菌性阴道炎具有儿童期生长发育生理特点,淋病奈瑟菌的检出常与直系亲属关系密切,需结合临床病史.各种致病菌的检出对临床诊断和治疗具有重要意义,正规合理选择抗生素后疗效明显.Objective Retrospective analysis of the detection rate of pathogenic bacteria,distribution and drug resistance of 526 children of genital tract secretions with bacterial culture,which were outpatients or inpatients in Beijing Children＇s Hospital from January to December in 2009,to provide for the clinical diagnosis to chose reasonable antibiotic therapy to improve treatment efflcacy,through the changes of bacteria of genital tract secretions resistance to antibiotics. Methods Analysed the exam results concluded from bacterial isolation and culture ,identification and susceptibility testing of 526 cases of genital tract secretions ,which were outpatients or inpatients in Baijing Children＇s Hospital from January to December in 2009. Results Except 50 eases were detected without bacteria growing ,there were 476 bacteria detected ,the ratio was 90. 5% （476/526）. Among 476 bacteria,there were 106 Gram-positive bacteria,the ratio was 22.3 % （106/476）,87 coagulase-negative staphylococci,the ratio was 18. 3% （87/476）. 283 pathogens were detected, the ratio was 59.5% （283/476） and among them there were 82 Gram-positive cocci ,the ratio was 17.2 % （82/476）, 173 Gram-negative bacilli ,the ratio was 36. 3% （173/476）. 12 Neisseria spp were detected,among them there were 10 Neisseria gonorrhoeae,the ratio was 2.1% （10/476） and 16 Fungi,the ratio was 3.4% （16/476）. 100% Staphylococcus aureus resistanted to penicillin G,the resis tance to azithromycin and erythromycin was 68. 8% ,the resistance to Clindamycin reached 31.2% ,the resistance ratio of streptococcus pyogenes to erythromycin and clindamycin was up to 84.6% ,the resistance ratio of Streptococcus pneumoniae to erythromycin,clindamycin and tetracycline was up to 100%. The resistance to penicillin G reached 10%,intermediate rate was 30%. The resistance to Cefotaxime,cefepime was 10% and 20%. 11.6 % of Haemophilus inyTuenzae could produce β-lactamases,which would resistent to antibiotic β-lactamases. The resistance to eotrimoxazole was

关 键 词：细菌 感染 阴道分泌物 耐药性 

分 类 号：R446.5[医药卫生—诊断学]