小儿急性阑尾炎病原菌构成及耐药性分析  

Analysis on composition of pathogenic bacteria and drug resistance in childhood acute appendicitis

作　　者：陈海燕[1] 曹松山[1] 段彦彦[1] 裴保方[1] 李燕[1] 

机构地区：[1]郑州市儿童医院,河南郑州450053

出　　处：《中国医院药学杂志》2014年第9期755-758,共4页Chinese Journal of Hospital Pharmacy

基　　金：2012年度"常州四药临床药学科研基金"科研项目(编号:CZSYJJ12011)

摘　　要：目的:了解某院儿童急性阑尾炎病原菌的分布特点及耐药情况,为临床合理选择抗菌药物提供依据。方法:利用医院信息系统调取相关数据,采用细菌药敏试验分析软件WHONET5.4,统计分析2010—2012年某院儿童急性阑尾炎病原菌的分布特点及耐药情况。结果:2010—2012年495例儿童急性阑尾炎脓液标本中共检出病原菌17种375株,其中革兰阴性菌354株,占94.40%,革兰阳性菌21株,占5.60%;排前3位的革兰阴性菌和革兰阳性菌分别为大肠埃希菌、铜绿假单胞菌、弗劳地枸橼酸杆菌和屎肠球菌、草绿色链球菌、粪肠球菌;3年间,革兰阴性菌对头孢哌酮/舒巴坦、哌拉西林/他唑巴坦耐药率分别为0.28%、0.85%,对亚胺培南、美罗培南耐药率均为0;革兰阳性菌对利奈唑胺、替考拉宁和万古霉素敏感率均为100.00%,未出现耐药菌株。结论:临床医师在抗感染治疗中,应根据儿童急性阑尾炎病原菌的分布特点及耐药情况,正确选择和合理使用抗菌药物,以减少耐药的发生,从而提高临床治愈率。OBJECTIVE To investigate the distribution of pathogenic bacteria and their drug resistance appendicitis, and to offer the foundation for clinical selection of reasonable antibacterial agents. METHODS in children＇s acute Related data were collected through the hospital information system. The characteristics of pathogenic bacteria and their drug resistance in chil- dren with acute appendicitis were analyzed by WHONET 5. 4 software. RESULTS From the year of 2010 to 2012,17 species and 375 strains of pathogens were detected out from the pus specimens of 495 cases of acute appendicitis in children. Among which there were 354 strains of Gram-negative bacteria, accounting for 94.40%, and 21 strains of Gram-positive bacteria, ac- counting for 5.60%. The top 3 Gram-negative bacteria and Gram positive bacteria were Escherichia coli, Pseudomonas aerugi nosa , Citrobacter f reundii , and Enterococcus f aecium , Streptococcus viridans , Enterococcus f aecalis. Drug resistant rates of Gram-negative bacteria to cefperazone-sulbactam and piperaeillin-tazobactam were 0. 28% and 0. 85%, and to imipenem and meropenem were 0. Gram-positive bacteria were highly sensitive to linezolid, teicoplanin and vancomycin, and no drug resistant strain was found. CONCLUSION In antidnfection treatment, the clinicians should correctly select and rationally use of antibi- otics on the basis of the characteristics of distribution of pathogenic bacteria and the drug resistance in children with acute ap- pendicitis, which could reduce the incidence of drug resistance, thereby enhancing the clinical cure rate.

关 键 词：儿童 急性阑尾炎 病原菌 耐药 抗菌药物 

分 类 号：R379[医药卫生—病原生物学]