2014年山东大学齐鲁儿童医院院内感染病原菌监测及耐药情况  

Nosocomial infection pathogen surveillance and drug resistance in Qilu children's hospital,Shandong University,2014

作　　者：朱效茹[1] 

机构地区：[1]山东大学齐鲁儿童医院,山东济南250022

出　　处：《预防医学论坛》2015年第11期870-873,共4页Preventive Medicine Tribune

摘　　要：目的了解山东大学齐鲁儿童医院病原菌分布及耐药情况,指导临床合理使用抗菌药物,减少耐药菌株的产生。方法对2014年1~12月的临床送检样本进行病原菌鉴定及耐药监测。采用微生物鉴定分析仪进行鉴定,K-B纸片扩散法进行药敏试验,根据CLSI 2010年标准判定耐药结果。结果 2014年1~12月山东大学齐鲁儿童医院共送检临床样本33 887份,病原菌检出2 813份,检出率8.30%。革兰阴性菌1 982株,占73.60%,主要是肺炎克雷伯菌（486株）、大肠埃希菌（456株）、非发酵阴性杆菌（449株,主要包括铜绿假单胞菌196株、嗜麦芽假单胞菌113株、鲍曼不动杆菌100株）;革兰阳性菌714株,占25.38%,其中葡萄球菌属523株,链球菌129株,肠球菌62株。占前10位的细菌依次为肺炎克雷伯菌、大肠埃希菌、金黄色葡萄球菌、阴沟肠杆菌、铜绿假单胞菌、肺炎链球菌、嗜麦芽假单胞菌、鲍曼/溶血不动杆菌、表皮葡萄球菌、弗劳氏枸橼酸杆菌,所占比例为17.28%（486株）、16.21%（456株）、12.16%（342株）、10.24%（288株）、6.97%（196株）、4.41%（124株）、4.02%（113株）、5.05%（100株）、3.31%（93株）、2.31%（65株）。共检出真菌117株,其中白色念珠菌105株,占3.73%。季也蒙念珠菌3株,近平滑念珠菌8株,热带念珠菌1株。结论儿童病原菌以革兰阴性杆菌为主,且多数革兰阴性菌对碳青霉烯类药物较敏感,对其它药物具有一定的耐药性,鲍曼复合不动杆菌感染具有增长趋势,且耐药性也在增加;革兰阳性球菌对万古霉素敏感性较高。Objective To understand the pathogen distribution and drug resistance in Qilu Children＇s Hospital,Shandong University,so as to guide the rational use of antimicrobial drugs,and reduce the production of drug resistant strains. Methods The pathogens were identified by microbial identification analyzer and the drug resistance was monitored by KB disk diffusion method for clinical inspection samples during January to December 2014.The drug susceptibility results were determined according to CLSI 2010 standard. Results From January to December 2014,33 887 specimens were detected in Qilu Children＇s Hospital,Shandong University,2 813 strains were detected,and the detection rate was 8.30%.1 982gram-negative strains were detected,and the detection rate was 73.60%,in which the major bacteria were Klebsiella pneumoniae（486strains）,Escherichia coli（456strains）,non-fermented negative bacilli（449strains,including Pseudomonas aeruginosa 196 strains,Pseudomonas aeruginosa 113 strains,Acinetobacter Bauman 100strains）;714gram-positive strains were detected,and the detection rate was 25.38%,in which 523 were Staphylococcus strains,129 were Streptococcus strains,and 62 were Enterococcus strains.The top ten bacteria were Klebsiella pneumoniae,Escherichia coli,Staphylococcus aureus,Enterobacter cloacae,Pseudomonas aeruginosa,Streptococcus pneumoniae,Pseudomonas maltophilia,Acinetobacter calcoaceticus-baumanni complex,staphylococcus epidermidis,and Citrobacter freundii,and the rates were 17.28%（486strains）,16.21%（456strains）,12.16%（342strains）,10.24%（288strains）,6.97%（196strains）,4.41%（124strains）,4.02%（113strains）,3.55%（100strains）,3.31%（93strains）,and 2.31%（65strains）.There were 117 fungal strains detected,including Candida albicans 105 strains,accounting for 3.73%.Monilia guilliermondii 3strains,Candida parapsilosis 8strains,and Oidium tropioale 1strain. Conclusion In children,gram-negative bacilli is the major pathogen,and the majority of gram-negative bacteria are sensitive t

关 键 词：儿童 病原菌 院内感染 

分 类 号：R378.1[医药卫生—病原生物学]