2014-2020年儿童腹水培养的细菌分布及耐药性分析  

Analysis of bacterial distribution and drug resistance in children ascites culture from 2014 to 2020

作　　者：方文婷[1] 林瑞琼 陈惠瑜[1] 邱华红[1] 钟汇 FANG Wenting;LIN Ruiqiong;CHEN Huiyu;QIU Huahong;ZHONG Hui(Department of Clinical Laboratory,Fujian Maternity and Child Health Hospital,Fuzhou,Fujian 350001,China)

机构地区：[1]福建省妇幼保健院检验科,福州350001

出　　处：《福建医药杂志》2021年第6期9-12,共4页Fujian Medical Journal

摘　　要：目的了解儿童腹水培养阳性标本中的细菌学分布特点及耐药情况,为临床选择抗菌药物提供依据。方法对2014年1月至2020年12月我院儿科送检的1268份腹水培养标本进行细菌培养、细菌鉴定、药敏分析。使用WHONET 5.6软件对数据进行统计分析。结果分离出非重复病原菌235株,阳性率为18.53%。其中革兰阴性菌占69.36%;革兰阳性菌占28.09%;真菌占2.55%。病原菌排位依次为大肠埃希菌、肺炎克雷伯菌、屎肠球菌、粪肠球菌、铜绿假单胞菌、金黄色葡萄球菌和阴沟肠杆菌。分离出的大肠埃希菌对哌拉西林/他唑巴坦、头孢他啶、头孢吡肟、头孢替坦、亚胺培南、美罗培南的敏感性较高(耐药率均<12%),头孢哌酮/舒巴坦的耐药率为13.4%。肺炎克雷伯菌的耐药率明显高于大肠埃希菌。分离出的屎肠球菌耐药率高于粪肠球菌,对利奈唑胺、万古霉素和替加环素均100.0%敏感。结论儿童腹水培养标本分离出的病原菌以革兰阴性菌为主,其对抗菌药物的耐药情况较为严重,正确合理使用抗菌药物,减少耐药菌的产生显得尤为重要。Objective To investigate the bacteriological distribution and drug resistance of positive samples of ascites culture in children,and to provide a basis for clinical selection of antimicrobial agents.Methods Bacterial culture,bacterial identification and drug sensitivity analysis were performed on 1268 ascites culture specimens from January 2014 to December 2020.WHONET 5.6 software was used for statistical analysis of the data.Results A total of 235 strains of non-duplicative pathogens were isolated and the positive rate was 18.53%.There were 163 gram-negative strains,accounting for 69.36%;66 gram-positive strains,accounting for 28.09%;6 strains of fungus,accounting for 2.55%.The top six pathogenic bacteria were Escherichia coli,Klebsiella pneumoniae,Enterococcus faecium,Enterococcus faecalis,Pseudomonas aeruginosa,Staphylococcus aureus and Enterobacter cloacae.The isolated Escherichia coli had high sensitivity to piperacillin/tazobactam,ceftazidime,cefepime,cefotetan,imipenem and meropenem(drug resistance rate<12%),and its drug resistance rate to cefoperazone/sulbactam was 13.4%.The drug resistance rate of Escherichia coli to most antibiotics was lower than that of Klebsiella pneumoniae.The isolated Enterococci were all 100.0%sensitive to linezolid,vancomycin and tigecycline,and the drug resistance rate of Enterococcus faecium was significantly higher than that of Enterococcus faecalis.Conclusion The pathogenic bacteria isolated from children's ascites culture specimens are mainly gram-negative bacteria,and their drug resistance to antibiotics is relatively serious.It is particularly important to use antibiotics correctly and rationally to reduce the emergence of drug-resistant bacteria.

关 键 词：儿童 腹水 病原菌 耐药性 

分 类 号：R725.7[医药卫生—儿科]