儿科导管相关性血流感染的病原菌分布与耐药性分析  

Distribution and drug resistance of pathogens causing catheter-related bloodstream infections in department of pediatrics

作　　者：刘素品 刘智 丁朝鹏 段玉龙 刘瑞云 岳慧芳[2] 

机构地区：[1]平顶山市第二人民医院儿科,河南平顶山467000 [2]平顶山市第一人民医院儿科,河南平顶山467000

出　　处：《中华医院感染学杂志》2016年第13期3095-3097,共3页Chinese Journal of Nosocomiology

基　　金：河南省科技厅基金资助项目(201348901JK)

摘　　要：目的分析医院儿科患儿发生导管相关性血流感染病原菌分布及耐药性,为其临床预防控制提供参考依据。方法选取2013年12月-2015年1月医院儿科收治211例留置中心静脉导管患儿为研究对象,对其发生导管相关性血流感染率、病原菌分布及耐药性进行调查和研究。结果 211例患儿发生导管相关性血流感染73例,感染率34.60%,共检出病原菌73株,其中革兰阳性菌28株占38.36%,革兰阴性菌32株占43.83%,真菌13株占17.81%;表皮葡萄球菌、溶血葡萄球菌、金黄葡萄球菌对呋喃妥因、万古霉素、利奈唑胺的耐药率均为0,鲍氏不动杆菌对头孢哌酮的耐药率最低为13.33%,克雷伯菌属对亚胺培南的耐药率最低为0,其他革兰阴性菌对孢哌酮的耐药率最低为22.22%,白色假丝酵母菌、热带假丝酵母菌、近平滑假丝酵母菌对两性霉素B及氟胞嘧啶的耐药率最高,达100.00%。结论儿科患儿发生导管相关性血流感染率较高,临床应根据病原菌分布及耐药性进行针对性的治疗。OBJECTIVE To observe the distribution and drug resistance of pathogens causing catheter-related bloodstream infections in department of pediatrics so as to provide guidance for clinical prevention and control.METHODS A total of 211 children who were treated with central venous catheter indwelling in hospitals from Dec2013 to Jan 2015 were recruited as the study objects.The incidence of catheter-related bloodstream infections and distribution and drug resistance of the pathogens were observed.RESULTS Of the 211 children,73had the catheter-related bloodstream infections,with the infection rate 34.60%.Totally 73 strains of pathogens were isolated,of which 28（38.36%）were gram-positive bacteria,32（43.83%）were gram-negative bacteria,and 13（17.81%）were fungi.The drug resistance rates of the Staphylococcus epidermidis,Staphylococcus haemolyticus,and Staphylococcus aureus to nitrofurantoin,vancomycin,and linezolid were 0;the drug resistance rate of the Acinetobacter baumannii to cefoperazone was the lowest（13.33%）;the drug resistance rate of the Klebsiella sppto imipenem was the lowest（0）;the drug resistance rate of other species of gram-negative bacteria to cefoperazone was the lowest（22.22%）;the drug resistance rates of the Candida albicans,Candida tropicalis,and Candida parapsilosis to amphotericin B and flucytosine were the highest（100.00%）.CONCLUSION The incidence of the catheter-related bloodstream infections is relatively high in the children of the department of pediatrics.It is necessary for the hospital to conduct targeted treatment based on the distribution and drug resistance of the pathogens.

关 键 词：导管相关性血流感染 病原菌 耐药性 

分 类 号：R378[医药卫生—病原生物学]