患儿医院感染的病原菌及耐药性分析  

Analysis of pathogens causing nocosomial infections to children and drug resistance

作　　者：沈维青[1] 刘斌[1] 刘柏林[1] 

机构地区：[1]淮阴卫生高等职业技术学校,江苏淮安223300

出　　处：《中华医院感染学杂志》2014年第9期2301-2303,共3页Chinese Journal of Nosocomiology

基　　金：江苏省卫生厅卫生职业技术教育研究基金项目(J201014)

摘　　要：目的研究住院患儿康复进程中医院感染的发生率、医院感染的病原菌分布,并研究病原菌的耐药性,以指导临床合理应用抗菌药物。方法选取2011年1月-2012年12月112例感染患儿分离培养病原菌,并对病原菌采用K-B琼脂法进行药敏试验,药敏结果判定严格按照NCCLS标准,所有数据采用SPSS13.0软件进行统计分析。结果 2011年1月-2012年12月共住院668例患儿,康复过程中发生感染112例,感染率16.8%,主要为上呼吸道感染占33.04%和下呼吸道感染占29.46%;共分离出病原菌124株,其中痰液占34.68%、血液占27.42%、尿液占14.52%、分泌物占11.29%、引流液占5.65%、其他来源的占6.45%,检出革兰阳性菌54株占43.55%、革兰阴性菌70株占56.45%;革兰阳性菌对替莫唑胺、乙酰唑胺和利奈唑胺的耐药率较低,革兰阴性菌对帕尼培南、亚胺培南和阿米卡星的耐药率较低。结论儿科住院患儿康复过程中医院感染发生率高,临床应采取措施控制感染的发生,如若感染发生首先分离培养病原菌,进行药敏试验,选取耐药率低的抗菌药物进行治疗。OBJECTIVE To study the occurrence rate of nosocomial infections and distribution of pathogens during the rehabilitation of children and study drug resistance of pathogens so as to guide the rational use of antibiotics in clinical practice.METHODS A total of 112cases of infected children from Jan 2011to Dec 2012were chosen to isolate and culture pathogens;Kirby-Bauer agar method was adopted for drug sensitivity test and the results were strictly determined according to NCCLS standard;all the data were statistically analyzed with SPSS 13.0software.RESULTS Of the 668children who were hospitalized in hospital from Jan 2011to Dec 2012,112cases suffered infections during rehabilitation with the infection rate of 16.8%;upper respiratory infection and lower respiratory infection were dominant,accounting for 33.04% and 29.46% respectively;a total of 124strains of pathogens were isolated from sputum（34.68%）,blood（27.42%）,urine（14.52%）,secretion（11.29%）, drainage liquid（5.65%）and other sources（6.45%）;54strains of gram-positive bacteria and 70strains of gramnegative bacteria were detected,accounting for 43.55%and 56.45%respectively;gram-positive bacteria had low drug resistance rate to temozolomide,acetazolamide and linezolid;gram-negative bacteria had low drug resistance rate to panipenem,imipenem and amikacin.CONCLUSIONS The occurrence rate of nosocomial infection in children during rehabilitation is high,so it is required to take corresponding measures to control infections in clinical practice;if infection occurs,it is necessary to first isolate and culture pathogens,then perform drug sensitivity test and finally select the antibiotics with low drug resistance rate for treatment.

关 键 词：医院感染 病原菌 耐药性 

分 类 号：R181.32[医药卫生—流行病学]