371例先天性心脏病围术期感染患儿血培养临床分析  

Analysis on distribution and drug-resistance of pathogens in 371 blood culture of preoperative in children with CHD

作　　者：杨望[1] 张雨平[1] 温恩懿[1] 胡斌[1] 吕奎林[1] 

机构地区：[1]第三军医大学新桥医院儿科,重庆400037

出　　处：《重庆医学》2015年第31期4386-4388,共3页Chongqing medicine

摘　　要：目的通过对371例先天性心脏病(CHD)围术期感染患儿血培养病原菌及药敏的数据分析,为CHD感染患儿提供合理的临床抗菌药物依据。方法对该科2011年8月至2014年10月收治的明确诊断为CHD的围术期感染患儿371例采血培养,并对阳性标本的菌株进行鉴定及药敏试验,按CLSI 2010版标准判读药敏试验结果。结果血培养检出病原菌43例,阳性率11.6%,其中革兰阳性菌23例(53.5%),革兰阴性菌19例(44.2%),白色念珠球菌1例(2.3%)。革兰阳性球菌中培养率最高的凝固酶阴性葡萄球菌(CNS)对青霉素及苯唑西林高度耐药,而对万古霉素、替考拉林完全敏感;革兰阴性菌对亚胺培南、美洛培南阿米卡星敏感。对照组血培养检出病原菌44例,阳性率8.2%。结论先天性心脏病患儿有更高的全身感染如败血症、脓毒症风险;且病原菌组成复杂,耐药形势严峻。应重视先天性心脏病感染患儿的血培养结果。Objective To investigate the distribution and drug-resistance of pathogens in positive blood culture of preioperatire infection in children based on 371 cases of congenital heart disease （CHD） in our hospital,so as to provide evidence for clinical rational use of antimierob-al agents. Methods Blood culture of 371 cases of preioperative infection children between August 2011 to October 2014 in hospital who were definited as CHD were selected, the interpretation results of drug sensitivity test were measured by CLSI 2010. Results The CHD group detected from blood culture pathogenic bacteria in 43 cases,the positive rat was 11.6% ,of which 23 （53.5 %） were Gram-positive bacteria, 19 （44.2 %） were Gram-negative bacteria, 1 （2.3%） cases of candida sporogenes. The highest rate of coagulase negative staphylococcus culture is Gram-positive bacteria （CNS） and it showed high resistance to penicillin and oxaeillin,it was sensitive to vancorrlycin and koala forest ;Gram-negative bacteria was sensitive to imipenem and amikacin. With the corresponding, pathogenic bacteria was detected in 44 cases of the control group,the positive rate was 8.2 %. Conclusion Children with congenital heart disease have higher systemic infections risk of septicemia and sepsis;and pathogen resistance composition is complex,the situation is grim. Attention should be paid on children with CHD blood culture results.

关 键 词：先天性心脏病 围术期感染 血培养 药敏 

分 类 号：R446.5[医药卫生—诊断学]