儿科住院患者多重耐药菌病原学特点分析  

Analysis of pathogenic characteristics of multidrug-resistant bacteria in pediatric inpatients

作　　者：贾维宁[1] 殷晓宁[1] 李娜[2] JIA Weining;YIN Xiaoning;LI Na(Zhangjiakou University,Hebei Zhangjiakou,075000,China;The First Hospital of Hebei Medical University Shijiazhuang)

机构地区：[1]张家口学院,河北张家口075000 [2]河北医科大学第一医院

出　　处：《中国病原生物学杂志》2023年第10期1209-1213,共5页Journal of Pathogen Biology

摘　　要：目的 分析本地区儿科住院患者多重耐药菌病原学特点。方法 收集2016-2022年某医院儿科所有住院部患儿送检标本的病原菌检出结果及相关临床资料为本次研究对象。采集患儿痰液、静脉血、中段尿等多种标本,进行病原菌培养、分离、鉴定及药敏试验。采用K-B纸片扩散法对耐甲氧西林金黄色葡萄球菌(MRSA)进行初筛后,采用PCR对β-内酰胺类耐药基因(mecA)、大环内酯类耐药基因(ermA、ermC)、四环素类耐药基因(tetM)、氨基糖苷类耐药基因(aac(6′)/aph(2′))进行扩增。采用分子信标定量PCR法对MRSA进行SCCmec分型。结果 本次研究中122例患儿为多重耐药菌感染,其中60.66%为男性患儿。检出多重耐药菌感染标本主要为痰液标本(59.02%),其次为静脉血标本(14.75%)。共检出122株多重耐药菌,其中64.48%为革兰阴性菌,主要为大肠埃希菌(35/122,28.69%)、肺炎克雷伯菌(22/122,18.03%)。38.52%为革兰阳性菌,主要为金黄色葡萄球菌(32/122,26.23%)、肺炎链球菌(10/122,8.20%)。新生儿重症监护病房63株,39株为革兰阴性菌。儿科重症监护室37株,23株为革兰阴性菌。普通儿科病房22株,13株为革兰阴性菌。药敏试验结果显示,35株大肠埃希菌对氨苄西林的耐药率为100%,对头孢他啶、头孢吡肟、左氧氟沙星、莫西沙星、庆大霉素、复方新诺明的耐药率较高,分别为48.57%、42.86%、62.86%、45.71%、65.71%、57.14%,对阿米卡星、亚胺培南和美罗培南的耐药率较低,分别为14.29%、17.14%、17.14%。32株金黄色葡萄球菌对青霉素的耐药率为100%,对红霉素、克林霉素、庆大霉素、四环素、环丙沙星、左氧氟沙星、复方新诺明的耐药率较高,分别为96.88%、78.13%、71.88%、53.13%、78.13%、68.75%、40.63%,未产生对万古霉素、利奈唑胺的耐药株。32株金黄色葡萄球菌中,共检出23株MRSA,检出率71.88%。23株MRSA中,耐药基因mecA、ermA、ermC、tetM、aac(6′)/apObjective The clinical and pathogenic characteristics of multidrug-resistant bacterial infections were ana-lyzed in pediatric inpatients in this region.Methods The pathogen detection results and related clinical data of all pedi-atric inpatient specimens from a certain hospital from 2016to 2022were collected as the research subjects.The various samples of sputum,venous blood,and mid stage urine were collected from children for pathogen cultivation,isolation,i-dentification,and drug sensitivity testing.After preliminary screening of Methicillin-resistant Staphylococcus aureus(MRSA)by K-B disk diffusion method,Theβ-Lactam resistance gene(mecA),Macrolide resistance gene(ermA,er-mC),tetracycline resistance gene(tet M),aminoglycoside resistance gene(aac(6′)/aph(2′))were amplified by PCR,and the SCCmec typing was performed by molecular beacon quantitative PCR.Results In this study,122children were infected with multidrug-resistant bacteria,of which 60.66%were boys.The main samples of multidrug-resistant bacterial infections detected were sputum samples(59.02%),followed by venous blood samples(14.75%).A total of 122multi-drug-resistant bacteria were detected,of which 64.48%were Gram negative bacteria,mainly Escherichia coli(35/122,28.69%)and Klebsiella pneumoniae(22/122,18.03%).38.52%were gram positive bacteria,mainly S.aureus(32/122,26.23%)and Streptococcus pneumoniae(10/122,8.20%).63strains of Gram negative bacteria were found in the neonatal intensive care unit,including 39strains of Gram negative bacteria.There were 37strains in the pediatric intensive care u-nit,including 23strains of Gram negative bacteria.There were 22strains in the general pediatric ward,including 13strains of Gram negative bacteria.The drug sensitivity test showed that the drug resistance rate of 35strains of E.coli to ampi-cillin was 100%,while the drug resistance rate to Ceftazidime,cefepime,Levofloxacin,Moxifloxacin,Gentamicin,and Tri-methoprim/sulfamethoxazole was high,48.57%,42.86%,62.86%,45.71%,65.71%,and 57.14%,respectively.The re-s

关 键 词：多重耐药菌 耐甲氧西林金黄色葡萄球菌 耐药基因 

分 类 号：R378[医药卫生—病原生物学]