儿科病原菌耐药分布及治疗策略  

Distribution of Strains Isolated From Department of Pediatrics and Its Countermeasure

作　　者：洪兰[1] 袁华兵[1] 

机构地区：[1]湖北省天门市第一人民医院,431700

出　　处：《中华妇幼临床医学杂志（电子版）》2014年第5期77-80,共4页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

摘　　要：目的探讨湖北省天门市第一人民医院儿科常见细菌类型,分析细菌耐药率与抗菌药物用药频度的相关性。方法选择2012年1月至12月湖北省天门市第一人民医院儿科病区送细菌室检查标本(痰液为83.8%,咽试纸为6.3%,尿液为2.5%,血液为2.0%,其他为5.4%)及其药物敏感试验结果为研究对象,对标本进行培养、鉴定及自动最低抑菌浓度测定,并统计分析抗菌药物用药频度和使用强度。本研究遵循的程序符合湖北省天门市第一人民医院人体试验委员会制定的伦理学标准,征得该委员会批准。结果 2012年分离出细菌菌株共计1 527株,其中革兰阴性(G-)杆菌为93.9%(1 434/1 527),包括大肠埃希菌(54.3%,779/1 434)、肺炎克雷伯菌(25.2%,361/1 434)、阴沟杆菌(9.8%,140/1 434)、铜绿假单胞菌(6.2%,89/1 434)和产气肠杆菌(4.5%,65/1 434);革兰阳性(G+)球菌为6.1%(93/1 527),包括金黄色葡萄球菌(25.8%,24/93)和表皮葡萄球菌(68.8%,64/93)等。G-杆菌耐药率与抗菌药物用药频度呈正相关关系(r=0.97,P<0.01)。结论湖北省天门市第一人民医院儿科病房以产超广谱β-内酰胺酶(ESBL)肠杆菌科细菌、凝固酶阴性葡萄球菌(MRCNS)为主要耐药菌,其抗菌药物用量与耐药性存在一定相关性。Objective To investigate the distribution of strains isolated from pediatrics department of Tianmen first people′s hospital in Hubei Province and analyze the correlation of the drug resistance rate and antibiotic defined daily dose（DDD）.Methods From January to December 2012,all samples（sputum specimens accounted for 83.8%,naval swabs 6.3%,urine 2.5%,blood 2.0% and the others 5.4%）were collected from the pediatrics department of Tianmen first people′s hospital.Strains were identified and the minimum bacteria-inhibiting level of antibiotics was measured,and antibiotics DDD and antibiotics use density（AUD）were statistically analyzed.The study protocol was approved by the ethical review board of investigation in human being of Tianmen first people′s hospital.Results A total of 1 527 strains were isolated.Among the detected 1 434（93.9%）gram negative bacilli,escherichia coli Klebsiella pneumonia,enterobacter cloacae,pseudomonas aeruginosa and enterobacter aerogenes accounted for 54.3%（779/1 434）,25.2%（361/1 434）,9.8%（140/1 434）,6.2%（89/1 434）and 4.5%（65/1 434）,respectively.Among the detected 93（6.1%）gram positive strains,staphylococcus aureus accounted for 25.9%（24/93）and staphylococcus epidermidis 68.8%（64/93）.There was a positive correlation between the drug resistance rate and DDD（r=0.97,P〈0.01）.Conclusions The major drug-resistant bacteria detected from pediatrics department of Tianmen first people′s hospital are extended-spectrum β-lactamase（ESBL）-releasing enterobacteriaceae and methicillin resistant coagulase negative staphylococci（MRCNS）.There is correlation between the antibiotic DDD and drug resistance rate.

关 键 词：儿科感染 耐药菌 使用强度 

分 类 号：R446.5[医药卫生—诊断学]