儿科常见病原菌分布及耐药性分析  

Distribution and drug resistance of common pathogenic bacteria in pediatrics department

作　　者：李长振[1] 饶菁菁[1] 黄永国[1] 艾洪武[1] 

机构地区：[1]武汉市妇女儿童医疗保健中心检验科,湖北武汉430016

出　　处：《中华医院感染学杂志》2013年第15期3797-3799,共3页Chinese Journal of Nosocomiology

摘　　要：目的了解及探讨医院儿科常见病原菌的分布及耐药特征,为治疗临床儿童肺炎的经验性用药提供依据。方法利用回顾性调查方法,对2011年1-12月儿科70 999份临床标本分离的病原菌分布及耐药性进行分析。结果 70 999份标本中共分离出病原菌9236株,分离率为13.01%,其中革兰阳性球菌占43.28%,以肺炎链球菌为主占23.33%,其次为金黄色葡萄球菌占10.90%和凝固酶阴性葡萄球菌占7.07%,MRSA和MRCNS检出率分别为11.22%和79.94%;支原体属检出率为10.46%;革兰阴性杆菌占41.64%,占前4位的依次为肺炎克雷伯菌、大肠埃希菌、流感嗜血菌及鲍氏不动杆菌,分别占11.24%、10.24%、9.72%、3.85%;大肠埃希菌、肺炎克雷伯菌及阴沟肠杆菌对氨苄西林的耐药率均>95.0%,大肠埃希菌和肺炎克雷伯菌对头孢曲松、头孢唑林及头孢呋辛耐药率>70.00%;肺炎克雷伯菌ESBLs检出率最高,为58.66%,大肠埃希菌的检出率次之,为55.01%。结论随着抗菌药物的持续使用,MRCNS及ESBLs检出率处于较高水平,应加强合理使用抗菌药物管理,严格控制耐药菌的产生和流行。OBJECTIVE To investigate the profile of distribution and antimicrobial resistance of pathogenic bacteria isolated from the pediatrics departments so as to guide the experimental medication for the clinical treatment of pneumonia. METHODS The distribution and drug resistance of the bacteria isolated from 70999 specimens in the pediatrics departments of the hospital from Jan to Dec, 2011 were retrospectively investigated. RESULTS A total of 9236 strains of pathogens were isolated from 70999 specimens with the isolation rate of 13.01%, among which the gram-positive cocci accounted for 41.3 %, the gram-negative bacilli 41.64%. Among the gram-positive cocci, the Streptococcus pneumoniae was the main pathogenic bacteria （23. 3%） , followed by Staphylococcus aureus （10.9%） and coagulase-negative Staphylococcus（7. 07%）, the detection rates of the MRSA and MRCNS were 11.22% and 79.94%, respectively; the detection rate of the Mycoplasma was 10.46% ; the Klebsiella pneurnoni- ae, Escherichia coli, Haemophilus influenza and Acinetobacter baumannii were the four leading species of the gram-negative bacilli, accounting for 11.24%, 10.24%, 9.72%, and 3.85%, respectively. The drug resistance rates of the K. pneumoniae, E. coli and Enterobacter cloacae to ampicillin were all higher than 95.0%; the drug resistance rates of the K. pneumonlae and E. coli to ceftriaxone, cefazolin, and cefuroxime were all over 70.00%. The detection rate of the ESBLs-producing K. pneumoniae was the highest （58.66%）, followed by the ESBLs-producing E. coli （55.01%）. CONCLUSION With the persistent use of the antibiotics, the detection rates of both MRCNS and ESBLs-producing strain are high, therefore it is necessary to strengthen the reasonable use of antibiotics so as to strictly control the emergence and prevalence of the drug resistant strains.

关 键 词：儿科 病原菌 支原体属 超广谱Β-内酰胺酶 耐药性 

分 类 号：R378[医药卫生—病原生物学]