儿童ICU患儿感染脑膜败血伊丽莎白菌与肠杆菌科病原菌的临床特征及耐药性分析  

Clinical characteristics of children with Elizabethkingia meningoseptica and Enterobacteriaceae infections in ICU and drug resistance

作　　者：殷丽军[1] 王传清[1] 陆国平[2] YIN Li-jun;WANG Chuan-qing;LU Ouo-ping(Children＇s Hospital of Fudan University,Shanghai 201102,China)

机构地区：[1]复旦大学附属儿科医院院内感染控制科,上海201102 [2]复旦大学附属儿科医院院重症医学科,上海201102

出　　处：《中华医院感染学杂志》2018年第14期2185-2188,共4页Chinese Journal of Nosocomiology

基　　金：上海宋庆龄基金会“恒基金”

摘　　要：目的探讨儿童重症监护病房(ICU)内血流及下呼吸道脑膜败血伊丽莎白菌(Elizabethkingia meningoseptica,EME)与肠杆菌科细菌感染/定植患者的临床特征并分析病原菌耐药性,为临床合理使用抗菌药物提供依据。方法回顾性分析医院2016年1月-12月ICU患者1595例,分析血流及下呼吸道检出的EME与肠杆菌科细菌感染/定植患者临床特征并检测病原菌耐药性。结果医院共收治ICU患者1595例,血流及下呼吸道共分离到52株EME,其中医院感染16例,定植36例,共分离到肠杆菌科细菌28株,其中医院感染13例,定植15例;EME血流及下呼吸道医院感染定植率(3.26%)高于肠杆菌科细菌(1.76%)(P<0.05);EME感染患儿气管插管比例高于肠杆菌科细菌(P<0.05);EME对包括头孢类、碳青霉烯类等多种抗菌药物表现出耐药。结论 EME血流及下呼吸道医院感染/定植率高于肠杆菌科细菌,且耐药形势更加严峻。OBJECTIVE To explore the clinical characteristics of children with Elizabethkingia meningoseptica（EME）and Enterobacteriaceae bloodstream and lower respiratory tract infection or colonization in intensive care unit（ICU）and analyze the drug resistance of the pathogens so as to provide guidance for reasonable clinical use of antibiotics.METHODS A total of 1595 children who were treated in hospitals from Jan 2016 to Dec 2016 were retrospectively analyzed,the clinical characteristics of the children with EME and Enterobacteriaceae bloodstream and lower respiratory tract infection or colonization were analyzed,and the drug resistance of pathogens was determined.RESULTS Of totally 1595 children who were treated in ICU,52 had EME bloodstream and lower respiratory tract infection or colonization,16 of whom had nosocomial infection,and 36 had colonization.28 had Enterobacteriaceae bloodstream and lower respiratory tract infection or colonization,13 of whom had nosocomial infections,and 15 had colonization.The incidence rate of EME bloodstream and lower respiratory tract infection or colonization was 3.26%,higher than 1.76% of Enterobacteriaceae bloodstream and lower respiratory tract infection or colonization（P〈0.05）.The proportion of the children with EME infection who received endotracheal intubation was significantly higher than that of the children with Enterobacteriaceae infection（P 〈0.05）.The EME strains were resistant to cephalosporins and carbapenems.CONCLUSION The incidence rate of the EME bloodstream and lower respiratory tract infection or colonization is higher than that of the Enterobacteriaceae,and the strains are highly drug-resistant.

关 键 词：脑膜败血伊丽莎白菌 肠杆菌 医院感染 定植 耐药 

分 类 号：R181.3[医药卫生—流行病学]