儿科重症监护病房儿童败血症的病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens of septicemia among patients in pediatric intensive care unit

作　　者：杨洋[1] 张秋月[1] 

机构地区：[1]哈尔滨医科大学附属第一医院儿科,哈尔滨150001

出　　处：《中国急救复苏与灾害医学杂志》2015年第2期108-110,共3页China Journal of Emergency Resuscitation and Disaster Medicine

摘　　要：目的：探讨儿科重症监护病房（PICU）血培养阳性败血症患儿的病原菌分布特点及耐药特征。方法回顾性分析2012年4月~2014年9月哈尔滨医科大学附属第一医院儿科重症监护病房收治的40例败血症的血培养及药敏试验结果。结果血培养阳性且诊断为败血症者占总收治的3.81%（40/1049），共培养出病原菌16种，革兰阳性菌27株，其中凝固酶阴性葡萄球菌16株，金黄色葡萄球菌2株，革兰阴性菌14株，其中肺炎克雷白杆菌6株，大肠埃希菌2株，念珠菌1株。革兰阳性菌对利奈唑胺、万古霉素敏感性高，对青霉素、氨苄西林、克林霉素普遍耐药，未发现万古霉素耐药菌株，革兰阴性菌对厄他培南、亚胺培南敏感性高，对氨苄西林、头孢类抗生素普遍耐药；真菌对常用抗真菌药物普遍敏感。结论凝固酶阴性葡萄球菌，肺炎克雷白杆菌仍是PICU中儿童败血症主要病原菌，对常见抗生素耐药率高物。Objective To investigate the distribution and resistance to antibiotics of pathogens of sepsis among the patients treated in the Pediatric Intensive Care Unit （PICU） of the First Affiliated Hospital of Harbin Medical University in the recent 3 years. Methods The results of blood cultures of 40 children with septicemia confirmed by hemoculture who were treated in this PICU during the period from April 2012 to March 2010 were analysed and the results of blood culture and antimicrobial susceptibility tests were conducted on the pathogens thus cultured. Results Positive blood culture accounted for 3.81% of the total number of septic patients（40/1049）, Gram-positive bacteria were isolated in 27 cases, coagulase negative staphylococcus （CNS） strains （16 cases） and Staphylococcus aureus （2 cases） being the common bacteria. Klebsiella pneumoniae （6 cases）, followed by Escherichia coli （2 cases）, were the major Gram-negative bacteria （14 cases）. Most Gram-positive isolates were sensitive to linezolid and vancomycin while demonstrated a strong resistance to Penicillin, ampicillin, and clindamycin, and vancomycin- resistant strain was not found. The Gram-negative bacteria thus cultured were sensitive to imipenem and ertapenem while resistant to ampicillin, and cephalosporins. The fungi strains thus cultured were generally sensitive to the commonly used antifungal agents. Conclusion CNS strains and Klebsiella pneumoniae remain the major pathogens PICU children sepsis, and they are resistant to common antibiotics.

关 键 词：败血症 病原菌 耐药性 

分 类 号：R722.131[医药卫生—儿科]