2017-2018年南宁地区儿童血流感染病原菌分布及耐药性分析  

Distribution and drug resistance of pathogens in children with bloodstream infection in Nanning

作　　者：刘敏雪 黄丽英[1] 梁嘉慧 王双杰[1] 岑贞娇[1] 曾尚娟[1] 黄战[1] 张欢 阮佳玲 LIU Minxue;HUANG liying;LIANG Jiahui;WANG Shuangjie;CEN Zhenjiao;ZENG Shangjuan;HUANG Zhan;ZHANG Huan;RUAN Jialing(Department of Laboratory Medicine in The Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region,Nanning 530000,China)

机构地区：[1]广西壮族自治区妇幼保健院检验科,南宁530000

出　　处：《实用医学杂志》2020年第4期527-531,共5页The Journal of Practical Medicine

基　　金：广西壮族自治区卫生厅自筹经费科研课题(编号:Z20190836);广西壮族自治区妇幼保健院2018年“育苗计划”青年项目(编号:GXWCH YMJH 2018008)。

摘　　要：目的分析南宁地区儿童血流感染(blood stream infection,BSI)病原菌分布及药敏情况,为本地区临床医生使用抗菌药物治疗BSI患儿提供流行病学依据。方法回顾性统计分析南宁市某医院2017-2018年儿童血培养数据,并分析主要致病菌的药敏结果及多重耐药菌情况。结果共38663名儿童送检血培养,血培养阳性1125例(2.91%),婴儿比新生儿及1~5岁儿童血培养阳性率高(P<0.001),外科真菌菌血症所占比例最高(38.64%)。检出致病菌1176株,以革兰阳性球菌为主(63.44%)。革兰阳性细菌(G+)检出前三位的是凝固酶阴性葡萄球菌(CNS)、金黄色葡萄球菌和肺炎链球菌,CNS与金黄色葡萄球菌对青霉素、红霉素均为高水平耐药。革兰阴性菌(G-)检出前几位的是铜绿假单胞菌、肺炎克雷伯菌、大肠埃希菌和沙门菌。大肠埃希菌和肺炎克雷伯菌对头孢菌素耐药率均很高,而铜绿假单胞菌耐药率低。真菌检出排前两位的是近平滑念珠菌和白色念珠菌,两者对氟胞嘧啶及两性霉素B耐药率不高,近平滑念珠菌对三唑类未出现耐药,而白色念珠菌对三唑类耐药率高达50%以上。结论南宁市儿童BSI病原菌非外科病房主要由革兰氏阳性球菌引起,而外科儿童BSI主要由真菌引起,临床医生应根据当地流行病学情况经验性指导用药。Objective To analyse the pathogenic organism of blood stream infection in children and its antibiotics sensitivity for references of clinical empirical medication.Methods In this retrospective study,we analyzed blood culture data of the children in the Maternal&Child Health Hospital of Guangxi Zhuang Autonomous Region from January 2017 to December 2018.We calculated positive rates of the blood culture positive microbiology.Then we analyzed the antibiotics sensitivity of the major pathogenic microbiology as well as multiple resistant bacteria.Results Blood cultures from 38663 children were examined.Blood cultures of 1125(2.91%)children were positive.The positive rate of the infants was higher than newborn and children aged 1~5 years(P<0.001).Fungi blood infection in surgery departments was the highest among all hospital departments(38.64%).1176 bacteria isolates were isolated from the blood cultures the majority being gram-positive(G^+)coccus taking up 63.44%.The major three G^+coccus isolated were CNS,Staphylococcus aureus and Streptococcus pneumoniae.Most CNS and Staphylococcus aureus were resistant to penicillin and erythromycin.The first four gram-negative(G^-)bacteria isolated were Pseudomonas aeruginosa,Klebsiella pneumoniae,Escherichia coli and Salmonella.Klebsiella pneumoniae,Escherichia coli were highly resistant to cephalosporin and Pseudomonas aeruginosa showed low resistance to antibiotics.The most common fungi were Anaerobe candida and Candida albicans,both with alower amphotericin B-resistance.All Anaerobe candida were sensitive to triazole antifungal agents but 50%Candida albicanswere triazole antifungal agents-resistant.Conclusion In Nanning BSI pathogenic organisms in children hospitalized in the surgery departments attribute to fungi and G^+coccus in other clinical departments.Physicians should empirically use antibiotics to treat BSI children according to the local epidemiological data.

关 键 词：儿童 血流感染 病原菌 耐药性 

分 类 号：R115[医药卫生—公共卫生与预防医学]