脑膜脓毒性伊丽莎白金菌感染的临床特征及细菌耐药性分析  

Clinical characteristics and bacterial resistance analysis of Elizabethkingiameningoseptica infection

作　　者：何娟[1] 符跃强[2] HE Juan;FUYueqiang(Department of Pediatric,Emeishan People's Hospital,Sichuan Province,Emeishan 614200,China)

机构地区：[1]四川省峨眉山市人民医院儿科,614200 [2]重庆医科大学附属儿童医院重症医学科/儿童发育疾病研究教育部重点实验室/儿科学重庆市重点实验室,重庆市400014

出　　处：《临床合理用药杂志》2018年第34期10-12,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析综合性儿童医院内脑膜脓毒性伊丽莎白金菌(EM)感染的分布、耐药性及感染者的临床特征,为临床抗菌药物治疗和预防提供依据。方法选择2016年3月-2017年2月在重庆医科大学附属儿童医院住院治疗的EM感染者53例,回顾性分析患儿一般情况、临床特征、分泌物/体液培养药敏结果及治疗转归。结果53例EM感染患儿中重症医学科住院患儿40例。53例患儿年龄8 d～14岁2个月,其中<3岁患儿40例。以痰液标本检出EM最多(50株)。最常见的基础疾病:重症肺炎、先天性心脏病和脓毒症。体外药敏试验发现EM对复方新诺明、哌拉西林/他唑巴坦抗生素耐药性最低。53例患儿经治疗好转出院41例,重症医学科中放弃治疗出院10例,治疗无效院内死亡2例。结论在综合性儿童医院重症医学科住院患儿较易发生EM感染,部分感染患儿预后不良。EM菌耐药性强,但对复方新诺明、哌拉西林/他唑巴坦敏感性好,应根据药敏结果合理选用抗生素。Objective To analyze the distribution,drug resistance and clinical characteristics of children with Elizabethkingiameningoseptica (EM) infection in a comprehensive children's Hospital,and provide evidence for clinical antibiotic treatment and prevention. Methods 53 cases of EM-infected patients who were hospitalized in the Children's Hospital of Chongqing Medical University from March 2016 to February 2017 were selected,the patient's general condition,clinical features,drug/humoral culture susceptibility results,and treatment outcomes were retrospectively analyzed. Results 53 patients with infection caused by EM were enrolled,among them,40 patients were hospitalized in the Department of critical care medicine. 53 patients were aged from 8 days to 14 years and 2 months,including 40 children <3 years old. The EM was detected by the sputum specimens(50 strains). The most common underlying diseases:severe pneumonia,congenital heart disease and sepsis. In vitro susceptibility testing found that EM had the lowest resistance to compound sulfamethoxazole and piperacillin/ tazobactam. Of the 53 patients,41 cases were discharged after treatment,10 cases in the critical care department were gaven up treatment and were discharged,and 2 cases patients died in hospital. Conclusion EM infection is prone to occurin critical care department of comprehensive children's hospital,and the prognosis is poor in some infected children. EM has strong drug resistance,while it is sensitive to compound sulfamethoxazole and piperacillin/tazobactam,and antibiotics should be selected according to the results of drug sensitivity.

关 键 词：脑膜脓毒性伊丽莎白金菌 耐药性 抗菌药物 临床特征 

分 类 号：R446.5[医药卫生—诊断学] R459.7[医药卫生—临床医学]