2013-2020年某三甲综合教学医院儿外科病原菌监测结果  

Surveillance results of pathogenic bacteria in pediatric surgery in a tertiary general teaching hospital from 2013 to 2020

作　　者：刘娜 王娜娜[2] 刘希杰[2] 纪冰[2] 丁雪梅 张晓丽[1] LIU Na;WANG Na-Na;LIU Xi-jie;JI Bing;DING Xue-mei;ZHANG Xiao-li(Binzhou Medical University,Yantai,Shandong 264003,China;不详)

机构地区：[1]滨州医学院护理学院,山东烟台264003 [2]滨州医学院附属医院,山东滨州256603

出　　处：《中华医院感染学杂志》2023年第11期1710-1715,共6页Chinese Journal of Nosocomiology

基　　金：山东省重点研发计划基金资助项目(2018GSF118207)。

摘　　要：目的分析某院儿外科住院患儿病原菌及其耐药性变迁,为临床合理用药提供参考。方法收集2013年1月-2020年12月滨州医学院附属医院儿外科住院患儿感染的病原菌,应用Cochran-Armitage趋势检验分析主要病原菌耐药率的年变化趋势。结果8年间共分离1230株病原菌,其中革兰阴性菌897株(72.93%),革兰阳性菌330株(26.83%),位于前四位的病原菌为大肠埃希菌、金黄色葡萄球菌、肺炎克雷伯菌和铜绿假单胞菌;标本来源中脓液占91.71%;主要感染人群为0~3岁患儿;大肠埃希菌对氨苄西林、头孢唑林、环丙沙星和左氧氟沙星的耐药率呈上升趋势(P<0.05);肺炎克雷伯菌对头孢唑林、头孢噻肟、环丙沙星的耐药率呈上升趋势(P<0.05);铜绿假单胞菌对替卡西林/克拉维酸的耐药率呈上升趋势(P<0.05);金黄色葡萄球菌对红霉素和克林霉素的耐药率在72.73%~96.00%之间,对头孢曲松、氨苄西林/舒巴坦、氯霉素和庆大霉素的耐药率呈下降趋势(P<0.05)。结论儿外科分离菌株以大肠埃希菌、肺炎克雷伯菌、铜绿假单胞菌和金黄色葡萄球菌为主,前三者对抗菌药物的耐药率呈上升趋势,耐药形势严峻,应定期监测并分析病原菌的耐药情况,从而有针对性的采取有效措施降低病原菌发生率和耐药率。OBJECTIVE To analyze the distribution of pathogenic bacteria and the changes of their drug resistance in children hospitalized in pediatric surgery,and to provide scientific basis for rational clinical use of drugs.METHODS The pathogenic bacteria of infected-children hospitalized in the Department of Pediatric Surgery of the Affiliated Hospital of Binzhou Medical University were collected from Jan.2013 to Dec.2020,and the Cochran-Armitage trend test was applied to analyze the annual trend of drug resistance rate of major pathogenic bacteria.RESULTS In the past 8 years,a total of 1230 strains of pathogenic bacteria were isolated over eight years,including 897 strains(72.92%)of gram-negative bacteria and 330(26.82%)strains of gram-positive bacteria,and the top four pathogens were Escherichia coli,Staphylococcus aureus,Klebsiella pneumoniae and Pseudomonas aeruginosa.Pus accounted for 91.70%of the specimens.The main infected population was children aged 0~3 years.The resistance rate of E.coli to ampicillin,cefazolelin,ciprofloxacin and levofloxacin showed an increasing trend(P<0.05).The resistance rate of K.pneumoniae to cefazolin,cefotaxime and ciprofloxacin showed an increasing trend(P<0.05).The resistance rate of P.aeruginosa to ticarcillin/clavulanate showed an increasing trend(P<0.05).The resistance rate of S.aureus to erythromycin and clindamycin ranged from 72.73%to 96.00%.And the resistance rate of S.aureus to ceftriaxone,ampicillin/sulbactam,chloramphenicol,and gentamycin resistance rates showed a decreasing trend(P<0.05).CONCLUSION The strains isolated from paediatric surgery in our hospital were mainly E.coli,K.pneumoniae,P.aeruginosa and S.aureus,and the resistance rate of the first three to antibacterial drugs was on the rise,and the situation of drug resistance was serious.The drug resistance of pathogenic bacteria should be regularly monitored and analysed so that targeted and effective measures could be taken to reduce the incidence and resistance rate of pathogenic bacteria.

关 键 词：儿外科 病原菌 抗菌药物 耐药性 监测 

分 类 号：R378[医药卫生—病原生物学]