安徽医科大学第二附属医院儿科多重耐药菌常见种类及敏感药物分析  

Analysis of common types and sensitive drugs of multidrug resistant bacteria in the Department of Peadiatric in the Second Affiliated Hospital of Anhui Medical University

作　　者：王强[1,2] 李全礼 刘德云[2] 王宁玲[1,2] WANG Qiang;LI Quan-li;LIU De-yun(Anhui Medical University,Hefei 230000,China)

机构地区：[1]安徽医科大学,安徽省合肥市230000 [2]安徽医科大学第二附属医院儿科,安徽省合肥市230000

出　　处：《临床合理用药杂志》2020年第18期8-10,共3页Chinese Journal of Clinical Rational Drug Use

摘　　要：目的分析安徽医科大学第二附属医院儿科2012—2013年多重耐药菌常见种类及敏感药物,并实施干预措施。方法选取安徽医科大学第二附属医院儿科2012—2013年所有住院患儿病原微生物检测中多重耐药菌阳性者103例次,分析多重耐药菌种类、多重耐药菌敏感药物敏感率、干预措施执行情况。结果103例次多重耐药菌中大肠埃希菌61例次、肺炎克雷伯菌19例次、铜绿假单胞菌5例次、屎肠球菌5例次、金黄色葡萄球菌5例次、粘质沙雷菌1例次、阴沟肠杆菌1例次、伤寒杆菌3例次、鲍曼不动杆菌3例次。在61例次多重耐药大肠埃希菌中,哌拉西林他唑巴坦敏感率为93.44%,头孢西丁敏感率为81.97%,阿莫西林克拉维酸敏感率为49.18%。在19例次多重耐药肺炎克雷伯菌中,哌拉西林他唑巴坦敏感率为89.47%,头孢西丁敏感率为57.89%,阿莫西林克拉维酸敏感率为26.31%。多重耐药菌感染(MDRO)患儿病情危重者占76%,年龄多<1岁,住院时间>10 d。结论年龄小、病情危重的感染性疾病患儿应常规行痰、尿、血标本病原微生物培养和药物敏感试验,监测多重耐药菌检出率,针对检出阳性者应严格执行干预措施,防止患儿间交叉感染;另针对有MDRO危险因素的患儿,应使用如哌拉西林他唑巴坦、头孢西丁、阿莫西林克拉维酸等敏感性高的药物治疗,以求有效治疗疾病并避免耐药菌耐药种类增多。Objective To analysis the common types and sensitive drugs of multidrug resistant bacteria in 2012-2013 the Department of Peadiatric in the Second Affiliated Hospital of Anhui Medical University,and implement interventions.Methods A total of 103 cases of multiple drug-resistant bacteria were selected from all hospitalized children in pediatrics of the Second Affiliated Hospital of Anhui Medical University from 2012 to 2013,analyze the types of multiple drug-resistant bacteria,the sensitive rate of multiple drug-resistant bacteria and the implementation of intervention measures.Results Among the 103 cases of multidrug-resistant bacteria,61 were Escherichia coli,19 were Klebsiella pneumoniae,5 were Pseudomonas aeruginosa,5 were Enterococcus faecium,5 were Staphylococcus aureus,1 was Serratia marcescens,1 was Enterobacter cloacae,3 were typhoid,3 were Acinetobacter baumannii.In 61 cases of multi drug resistant Escherichia coli,the sensitivity rate of piperacillin tazobactam,cefoxitin and amoxicillin clavulanic acid was 93.44%,81.97%and 49.18%,respectively.In 19 cases of multi drug resistant Klebsiella pneumoniae,the sensitivity rate of piperacillin tazobactam,cefoxitin and amoxicillin clavulanic acid were 89.47%,57.89%and 26.31%,respectively.76%of the children with MDRO infection were in critical condition,most of them were less than 1 year old,and the length of stay was more than 10 days.Conclusion In order to prevent cross infection among children with infectious diseases,the bacterial culture of sputum,urine and blood samples and drug sensitivity test should be carried out regularly.In addition,in order to effectively treat the MDRO and avoid the increase of drug resistance,high sensitive drugs such as piperacillin tazobactam,cefoxitin and amoxicillin clavulanic acid should be used.

关 键 词：感染 儿童 多重耐药菌 检测干预 

分 类 号：R446.5[医药卫生—诊断学] R725[医药卫生—临床医学]