62例重症手足口病患儿伴发细菌性感染病原菌的分布及其耐药性分析  

Analysis of Distribution and Drug Resistance of Pathogenic Bacteria in 62 Children with Severe Hand-foot-mouth Disease Complicated with Bacterial Infection

作　　者：夏良贤[1] 乔玉林[1] XIA Liang-xian;QIAO Yu-lin(Clinical Laboratory,Zhengyang County Center for Disease Control and Prevention,Zhengyang He'nan 463600,China)

机构地区：[1]正阳县疾病预防控制中心检验科,河南正阳463600

出　　处：《抗感染药学》2021年第10期1460-1463,共4页Anti-infection Pharmacy

摘　　要：目的:分析重症手足口病患者合并细菌性感染病原菌的分布及其耐药情况,为临床合理用药提供参考。方法:选取正阳县疾病预防控制中心2019年3月—2021年3月收治的重症手足口病合并细菌性感染62例病历资料,统计其患儿痰液标本的细菌培养、鉴定及药敏试验结果,分析其病原菌的分布特点以及不同病原菌的耐药特点。结果:62例患儿标本中检出66株病原菌,其中革兰阴性菌45株(占68.18%)、革兰阳性菌21株(占31.82%);TOP 3病原菌为大肠埃希菌(占27.27%)、肺炎克雷伯菌(占18.18%)和铜绿假单胞菌(占12.12%);产超广谱β-内酰胺酶和头孢菌素酶C菌株数量多于单产超广谱β-内酰胺酶或头孢菌素酶C酶菌株;药敏试验结果发现大肠埃希菌对哌拉西林、妥布霉素耐药率均高于72.00%,肺炎克雷伯菌对妥布霉素、庆大霉素耐药率也均高于65.00%,铜绿假单胞菌对头孢他啶、哌拉西林耐药率也均高于60.00%。结论:重症手足口病患儿伴有细菌性感染的病原菌以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌为主,其对不同抗菌药物的耐药情况不尽相同,临床应根据细菌药敏结果合理选用抗菌药物以配合抗病毒治疗。Objective: To analyze the distribution and drug resistance of pathogenic bacteria in children with handfoot-mouth disease(HFMD) complicated with bacterial infection, and provide reference for clinical rational drug usage.Methods: The medical records of 62 cases of severe HFMD complicated with bacterial infection admitted to the hospital from March 2019 to March 2021 were selected. Bacterial culture, identification and drug sensitivity test results of sputum samples of the children were analyzed, and the distribution characteristics of pathogenic bacteria and drug resistance characteristics of different pathogenic bacteria were analyzed. Results: 66 strains of pathogenic bacteria were detected in the samples of 62 children, including 45 strains of Gram-negative bacteria(68.18%) and 21 strains of Grampositive bacteria(31.82%). The TOP 3 pathogens were Escherichia coli(27.27%), Klebsiella pneumoniae(18.18%) and Pseudomonas aeruginosa(12.12%). The number of strains producing ultra-broad spectrum β-lactamase(ESBLs) and cephalosporinase C(Amp C) were more than those producing ESBLs or Amp C. Drug sensitivity test results showed that the drug resistance rates of EScherichia coli to piperacillin and tobramycin were higher than 72%, the drug resistance rates of Klebsiella pneumoniae to tobramycin and gentamicin were higher than 65%, and the drug resistance rates of Pseudomonas aeruginosa to ceftazidime and piperacillin were higher than 60%. Conclusion: The pathogenic bacteria associated with bacterial infection in children with severe HFMD were mainly Escherichia coli, Klebsiella pneumoniae and Pseudomonas aeruginosa, and their drug resistance to different antibacterials were different. For children with HFMD, the rational selection of antibacterial agents should be based on the drug resistance of pathogenic bacteria to cooperate with antiviral therapy.

关 键 词：重症手足口病 细菌性感染 抗菌药物 耐药性 

分 类 号：R915[医药卫生—微生物与生化药学] R969.3[医药卫生—药学]