2019—2023年某儿童医院儿外科病原菌分布特征及耐药性变迁  

Distribution characteristics and resistance rate changes of pathogens in pediatric surgery at a children's hospital from 2019 to 2023

作　　者：孙雪荣 孙爱丽 夏琳 徐莉莉 丁伟 SUN Xue-rong;SUN Ai-li;XIA Lin;XU Li-li;DING Wei(Qingdao Women and Children's Hospital,Qingdao 266034,China;Qingdao Shibei District Maternal and Child Health and Family Planning Service Center;Peking University People’s Hospital,Qingdao&Women and Children’s Hospital,Qingdao University)

机构地区：[1]青岛市妇女儿童医院,山东青岛266034 [2]青岛市市北区妇幼保健计划生育服务中心 [3]北京大学人民医院青岛医院青岛大学附属妇女儿童医院

出　　处：《中国消毒学杂志》2024年第10期747-749,753,共4页Chinese Journal of Disinfection

基　　金：青岛市市级临床重点专科项目(2022-2024)。

摘　　要：目的了解儿外科住院患儿病原菌分布特点及耐药性变迁,为临床合理用药和治疗提供参考。方法采用回顾性方法,对2019—2023年某医院儿外科住院患儿送检的非重复标本细菌培养及药敏试验结果进行分析。结果共检出病原菌2188株,革兰阴性菌和革兰阳性菌分别为1527株(69.78%)和609株(27.83%),构成比居前4位的病原菌为大肠埃希菌、铜绿假单胞菌、金黄色葡萄球菌和肺炎克雷伯菌;标本来源中,腹腔脓液占79.52%,软组织脓液占5.90%;大肠埃希菌对头孢曲松的耐药率呈上升趋势(P<0.05),金黄色葡萄球菌对青霉素的耐药率在81.8%~100.0%,对红霉素和克林霉素的耐药率在51.0%~70.8%,呈波动趋势。结论该院儿外科分离菌株以革兰阴性杆菌为主,主要检出于腹腔脓液和尿液标本中,其中大肠埃希菌对头孢菌素耐药率呈上升趋势。金黄色葡萄球菌主要检出于软组织脓液,骨科脓液以及静脉血标本中。应定期监测并分析病原菌的耐药情况,严格抗菌药物应用指征,防止和减缓耐药菌的产生。Objective To analyze the distribution characteristics of pathogens and the changes of drug resistance rate,and to provide references for rational clinical use of drug and treatment.Methods Non-repetitive strains of bacterial culture were collected in department of pediatric surgery from 2019 to 2023 and analyzed retrospectively.Results A total of 2188 pathogens were detected,including 1527 gram-negative bacteria(69.78%)and 609 Gram-positive bacteria(27.83%).The top four pathogens were Escherichia coli,Pseudomonas aeruginosa,Staphylococcus aureus and Klebsiella pneumoniae.Peritoneal and soft tissue pus accounted for 79.52%and 5.90%respectively among all specimens.The resistance rate of E.coli to ceftriaxone showed an increasing trend(P<0.05).The resistance rate of S.aureus to penicillin ranged from 81.8%to 100%,that of erythromycin and clindamycin fluctuated between 51.0%and 70.8%.Conclusion Gram negative bacilli were the main strains isolated from pediatric surgery in our hospital,which are mainly detected in abdominal pus and urine samples,while S.aureus is mainly detected in soft tissue pus,orthopedic pus,and venous blood.The drug resistance of pathogens should be monitored and analyzed regularly,and the indication of antibiotic application should be strictly enforced to prevent and slow down the generation of drug-resistant bacteria.

关 键 词：儿外科 病原菌 临床分布 耐药率 

分 类 号：R187.2[医药卫生—流行病学]