儿童血培养检出菌的构成与凝固酶阴性葡萄球菌在血流感染中的致病性研究  

The composition of detection bacteria in blood culture of children patients and the pathogenicity of coagulase-negative staphylococci in bloodstream infection

作　　者：刘新光[1] 崔玉娇[2] 吴昊[1] 王盛华[1] 李梅[1] 郭映辉[1] LIU Xinguang;CUI Yujiao;WU Hao(Department of Clinical Laboratory,Children’s Hospital of Hebei Province,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北省儿童医院检验科,石家庄市050031 [2]河北省石家庄市妇产医院检验科

出　　处：《河北医药》2018年第7期1099-1101,1105,共4页Hebei Medical Journal

摘　　要：目的对近五年河北省儿童医院血培养阳性标本检出菌的构成与变迁情况进行回顾分析,为儿童血流感染的临床诊治、院内感染的监测提供依据。方法样本来源于2011年1月1日至2015年12月31日河北省儿童医院临床疑似血流感染的血培养阳性样本21 990份,去除同一患者重复培养的相同鉴定结果。血培养采用BD公司BACTEC FX全自动血培养仪及其配套的儿童血培养瓶,细菌鉴定主要在Phoenix 100全自动微生物分析仪完成。结果五年间血培养阳性率随年份增加呈降低趋势。在检出的革兰阳性球菌中,凝固酶阴性的葡萄球菌、金黄色葡萄球菌、肠球菌属分列前三位;革兰阴性杆菌中,位于前三位的是肺炎克雷伯氏菌、非发酵革兰阴性杆菌与大肠埃希氏菌。结论五年内检出菌的构成比有所变化,掌握检出菌的分布特征以及变迁情况,联合CRP、PCT与阳性报警时间可对判断病原菌、监控院内感染、指导临床合理使用抗生素以及提高血流感染患儿的诊治均具有极为重要的意义。Objective To retrospectively analyze the composition and changes of detection bacteria in blood culture of children patients in Children’s Hospital of Hebei Province in the past five years in order to provide basis for clinical diagnosis and treatment of blood stream infections as well as nosocomial infections surveillance.Methods The 21,990 blood specimens were collected from the patients whose blood culture specimens were clinically suspected bloodstream infection in Children’s Hospital of Hebei Province from January 2011 to December 2015,which were removed the same results in the same patients with repeat culture.BACTEC FX automated blood culture system and child-specific bottles were used for blood culture,and identification of bacteria was performed by BD Phoenix 100 automated microbial analyzer.Results The positive rate of blood culture showed a decrease trend in recent five years.Among detected gram-positive cocci,coagulase-negative Staphylococci,Staphylococcus aureus,Enterococcus were the top three ones,in gram-negative bacilli,the top three ones were Klebsiellapneumoniae,non-fermenting gram-negativebacilli and Escherichia coli.Conclusion The composition ratio of bacteria detected in blood culture changed in recent five years is changes at some extent.To grasp the distributional characteristics and diversify status of detected bacteria combined with CRP,PCT detection paly an important role in judging pathogenic bacteria,monitoring nosocomial infection,guiding clinical rational use of antibiotics and improving diagnosis and treatment of bloodstream infection of children patients.

关 键 词：血培养 儿童 构成比 凝固酶阴性葡萄球菌 

分 类 号：R446.51[医药卫生—诊断学]