河北省2011年儿童医院多重耐药菌分布及耐药性  

Clinical distribution and drug resistance of multidrug-resistant bacteria in Children's Hospital in Hebei in 2011

作　　者：温婵[1] 耿蓉娜[1] 赵博[1] 

机构地区：[1]河北省儿童医院医院感染管理处,河北石家庄050031

出　　处：《现代预防医学》2013年第20期3756-3759,共4页Modern Preventive Medicine

摘　　要：目的了解儿童医院临床多重耐药菌分布特点及其对抗菌药物的耐药情况,为临床合理使用抗菌药物提供参考。方法选取2011年送检阳性的4 164份标本,按常规方法分离培养及鉴定病原菌,根据标准筛选MDRO,采用纸片扩散(K-B)法进行药物敏感试验。结果检出多重耐药菌1 620株,G-菌占56.30%,G+菌占43.70%。所分离的G+菌中首位的是凝固酶阴性葡萄球菌,其对万古霉素耐药率为32.90%、未发现对环丙沙星耐药菌株,且适于儿童用药,可作为临床经验首选用药。G-菌中占前两位的是大肠埃希菌和肺炎克雷伯菌,构成比分别为29.75%和15.56%,其对青霉素类和头孢菌素类多种抗生素耐药,对头孢西丁、头孢哌酮/舒巴坦、阿米卡星、碳青霉稀类抗菌药物(美洛培南)高度敏感,耐药率﹤30%,可作为首选临床经验用药。结论分离株耐药现象普遍存在,对多种抗菌药物的耐药性严重。因此,临床应重视病原学检查,开展细菌耐药性监测,合理使用抗生素。OBJECTIVE The study aimed to investigate the clinical distribution and drug resistance of multidrug-resistant bacteria in Children＇s Hospital, so to provide references for the rational use of antibacterial drugs. METHODS A total of 4 164 specimens received by the hospital in 2011 and tested pathogen-positive were selected. Pathogens isolated by regular methods from the specimens were identified and multidrug-resistant organisms （MDROs） among the identified pathogens were selected by standard screeing methods. Kirby-Bauer （K-B） method was used to test susceptibility of the MRDOs. RESULTS A total of 1 620 strains of multidrug-resistant bacteria were detected, including 56.30% of gram-negative bacteria and 43.70% of gram-positive bacteria. Coagulase-negative Staphylococci （CNS） were the most prominent MDRO among the iso- lated gram-positive bacteria. Resistance rate of the isolated CNS against vancomycin was 32.90%. No ciprofloxacin-resistant CNS strains were detected, suggesting that ciprofloxacin could be used as the preferred drug for the treatment of infections in children. The two most prominent gram-negative MDRO among the isolated bacteria were Escherichia coli and Klebsiella pneumoniae, accounting for 29.75% and 15.56%, respectively. The isolated E. coli and K. pneumoniae were resistant against muhiple antibiotics, including penicillins and cephalosporins, and were highly susceptible to cefoxitin, amikacin, and car- bapenem antibiotics （meropenem）, suggesting that the antibiotics could also be used as the preferred drugs clinically. CONCLUSION Resistance against multiple antibacterial drugs is a common feature among the isolated strains. Pathogenology examination, monitoring of drug resistance, and rational use of antibiotics should be emphasized in clinical practices.

关 键 词：儿童 细菌 抗生素 耐药性 多重耐药 

分 类 号：R37[医药卫生—病原生物学]