小儿大肠埃希菌血流感染的临床特点与药物敏感分析  

Clinical distribution and drug sensitivity of bloodstream infection induced by Escherichia coli in children

作　　者：周凯[1] 吴鹏[1] 胡静[1] 徐飞[1] 王晓卫[1] ZHOU Kai WU Peng HU Jing XU Fei WANG Xiao - wei(Children＇s Hospital Affiliated to Nanjing Medical University,Nanjing Jiangsu 210008 ,China)

机构地区：[1]南京医科大学附属儿童医院,江苏南京210008

出　　处：《中国消毒学杂志》2017年第7期660-663,共4页Chinese Journal of Disinfection

基　　金：江苏省人社厅"六大人才高峰"资助项目(2016-WSN-193);南京市科委项目(201605048)

摘　　要：目的分析儿童大肠埃希菌血流感染的临床特点及其对常用抗菌药物的药敏试验结果,为防控相关感染提供依据。方法回顾性收集某医院2013年1月-2015年10月确诊为大肠埃希菌感染的82例患儿临床资料,分析阳性菌株的血清分型与药物敏感性试验结果。结果发生大肠埃希菌血流感染的患儿以年龄在30 d内最多,占54.9%;有53.6%的患儿来自新生儿科,20.7%患儿患有血液肿瘤病;临床分离的大肠埃希菌的血清型以O142K86、O126K71、O44K74、O127K63、O55K59居前5位,其中以O142K86型最为多见,占24.4%。药敏试验显示,临床分离株对氨苄西林和头孢唑林的耐药率最高,分别为76.8%和70.7%;头孢亚胺培南和和哌拉西林他唑巴坦最为敏感,敏感染率均达到了97.6%。结论该医院大肠埃希菌血流感染发病以新生儿及存在血液病等基础病患儿发病率高,易侵犯中枢神经系统而诱发化脓性脑膜炎。Objective To investigate the clinical characteristics of bloodstream infection induced by Escherichia coli isolated from pediatric patients and its drug sensitivity,so as to provide basis for the prevention and control of related infections.Methods A total of 82 cases of bloodstream infection induced by Escherichia coli from January 2013 to October 2015 were collected and retrospectively analyzed. The results of serological analysis and drug sensitivity test of positive strains were analyzed. Results Most of the cases（ 54. 9%） were aged less than 30 d with 53. 6% of them from neonatology department,20. 7% associated with hematopathy. O142K86（ 24. 4%） was the most common type in distribution of serotypes and O126K71,O44K74,O127K63,O55K59 were in top 2-5. Drug sensitivity test showed that the resistance rates of Ampicillin and Cefazolin were the highest（ 76. 8% and 70. 7%） and the sensitivity rates of Imipenem and Piperacillin tazobactam were the highest（ 97. 6%）. Conclusion The incidence of the bloodstream infection induced by Escherichia coli are more common in new born children and the children with underlying diseases,such as hematonosis in this hospital. They are proned to invade the central nervous system and induce purulent meningitis.

关 键 词：大肠埃希菌 血流感染 血清型 药物敏感 儿童 

分 类 号：R197.323[医药卫生—卫生事业管理]