儿童医院感染败血症病原菌及感染率10年变迁  

The nosocomial septicemia in children: A 10-year analysis of etiology and morbidity changes

作　　者：叶小姣[1] 娄鹏程[1] 金江兵 梁亚峰[1] 卢露[1] 单小鸥[1] 

机构地区：[1]温州医科大学附属第二医院育英儿童医院儿童重症监护病房,浙江温州325027

出　　处：《温州医科大学学报》2015年第11期834-837,共4页Journal of Wenzhou Medical University

摘　　要：目的:调查儿童(非新生儿)医院感染败血症病原及预后、感染率情况,为临床防治提供科学依据。方法:对自2005年1月至2014年12月间我院68例医院感染败血症的临床资料进行回顾性调查分析。结果:我院10年儿童(非新生儿)医院感染败血症感染率为0.054%,2005-2010年总体感染率(为0.091%)较高,2010年之后感染率(为0.035%)明显下降,差异有统计学意义(x2=16.530,P=0.000)。共检出70株病原菌,其中革兰阳性菌35株(占50.0%),革兰阴性菌30株(占42.9%)、真菌5株(占7.1%)。居前3位的革兰阳性菌依次为凝固酶阴性葡萄球菌、口腔链球菌、金黄色葡萄球菌。革兰阴性菌前4位依次为大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和沙门杆菌。肠杆菌和肺炎克雷伯菌、铜绿假单胞菌均存在多重耐药现象。结论:我院儿童(非新生儿)医院感染败血症2005年1月至2014年12月感染率为0.054%,2010年起感染率明显下降。病原菌构成以革兰阳性菌为主,构成比前后5年无明显差异。Objective： Investigate the clinical features and morbidity of nosocomial septicemia in children.Anlyse pathogenic bacteria and antibiotic resistance of these infections to improve the control and treatment. Method： A total of 68 patients of nosocomial septicemia in Yuying Children＇s Hospital from January 2005 to December 2014 were enrolled in the retrospective study. Results： The infection rate of nosocomial septicemia （non-neonates） was 0.054% in Yuying Children＇s Hospital during 10 years. Which was totally 0.091% durling 2005-2009, statistically significant higher than 0.035% durling 2010-2014 （x2=16.530, P=0.000）. 70 strains of pathogens were isolated from blood in 10 years. In which gram-positive bacteria accounted for the highest pro- portion （35 strains, 50%）, gram-negative bacterial was 42.9% （30 strains）, pathogenic fungi was 7.1% （5 strains）. The predominant three pathogens of G＋ bacteria were coagulase negative staphylococci, oral streptococci and staphylococcus aureus. The predominant four pathogens of G- bacteria were escherichia coli, klebsiella pneu- moniae, pseudomonas aeruginosa and Salmonella. Escherichia coli, klebsiella pneumoniae and pseudomonas aeruginosa were found to have multidrug resistance. Conclusion： The infection rate of nosocomial septicemia （non-neonates） was 0.054% in Yuying Children＇s Hospital which Affiliated to Wenzhou Medical College dur- ing 2005-2014. This infection rate has a decrease trend during 2005-2014 （x2=16.530, P=0.000）. Gram-positive bacteria were the major pathogens in nosocomial septicemia in children （non-neonates）. There was no significant difference in pathogenic bacteria proportion between 2005-2009 and 2010-2014.

关 键 词：儿童 医院感染 败血症 耐药性 

分 类 号：R631.3[医药卫生—外科学]