郴州地区儿童血培养病原菌构成及耐药性分析  

Children′s blood culture pathogens composition and resistance analysis of Chenzhou

作　　者：徐桂珍[1] 李胜涛[1] 史文元[1] 朱军民[1] 彭小友 徐玉娟[1] 

机构地区：[1]郴州市第一人民医院儿童医院检验科,湖南郴州423000

出　　处：《国际检验医学杂志》2015年第10期1389-1391,共3页International Journal of Laboratory Medicine

摘　　要：目的了解郴州地区儿童血培养病原菌分布及耐药情况。方法采集来自本院血培养标本检出的各类细菌,并对标本的送检科室、来源的患儿年龄及各类细菌的药敏实验数据进行分析。结果检出各类病原菌共计413株,其中,革兰阳性球菌216株、革兰阴性杆菌176株、真菌21株。检出细菌排名前5的病原菌分别为葡萄球菌属、肠球菌属、大肠埃希菌、肺炎克雷伯菌、链球菌属。检出阳性菌株数量排前5名依次是新生儿重症监护病房(NICU)、新生儿科、呼吸科、儿科重症监护病房(PICU)、神经内科。检出患儿年龄主要集中于3岁以下的儿童及婴幼儿。革兰阳性球菌对青霉素G和红霉素的耐药率较高,其次是喹诺酮类药物,未发现耐万古霉素葡萄球菌和肠球菌。革兰阴性杆菌最敏感的药物是亚胺培南和美洛培南。真菌对5种临床常用抗真菌药物灵敏度均较高。结论本院儿童血培养检出病原菌以葡萄球菌为主,但是不同科室的构成比例并不一致;3岁以下儿童血流感染的可能性大;本院真菌检出率较高,占5.1%,与本院采用血培养真菌瓶有关;血培养分离菌株的耐药性较高,合理使用抗菌药物可以减少耐药菌的产生。Objective To investigate the distribution of children′s blood culture pathogens and drug resistance in Chenzhou re‐gion .Methods Collected all kinds of bacteria from blood culture ,recorded the source department ,the child patients′age ,and drug sensitivity data of bacteria for analysis .Results A total of 413 strains were isolated ,among them ,216 strains were gram‐positive cocci ,176 strains were gram‐negative bacilli ,21 strains were fungi .The top four pathogenic bacteria in isolate number were Staphy‐lococcus aureus ,E .coli ,Klebsiella pneumoniae ,Streptococcus .The top five Department from which the most stains were isolated were NICU ,neonatology department ,pneumology department ,PICU ,department of neurology .The children′s ages were mainly un‐der the age of three .The resistant rate of Gram positive cocci to penicillin G and erythromycin were very high ,followed by quinolo‐nes ,and vancomycin resistant staphylococcus and enterococcus was not found .The most sensitive drugs for the treatment of Gram‐negative bacillus were imipenem and meropenem .The drug sensitivity of fungal to five kinds of commonly used clinical anti‐fungal were high .Conclusion The isolates of children′s blood culture were mainly staphylococcus ,the proportion of different departments varied .Children under the age of three were most likely to have bloodstream infections .The detection rate of fungal in the hospital were 5 .0% ,which was relatively high and associated with the usage of blood culture bottle for fungi .The isolates from blood cul‐tures were with high rate of drug resistance ,and the rational use of antibiotics can reduce the generation of drug‐resistant bacteria .

关 键 词：血培养 病原菌构成 耐药性 

分 类 号：R446.5[医药卫生—诊断学]