2018-2021年儿童血流感染病原菌分布及耐药性分析  

Distribution and Drug Resistance of Pathogenic Bacteria in Bloodstream Infections in Children from 2018 to 2021

作　　者：刘明雷 姚玲 李小超 高春燕[1] Liu Minglei;Yao Ling;Li Xiaochao;Gao Chunyan(Tangshan Maternal and Child Health Hospital,Key Laboratory of Molecular Medicine for Abnormal Development and Related Diseases in Tangshan,Hebei Tangshan 063000,China)

机构地区：[1]唐山市妇幼保健院,唐山市发育异常与相关疾病分子医学重点实验室,河北唐山063000

出　　处：《儿科药学杂志》2025年第1期48-51,共4页Journal of Pediatric Pharmacy

基　　金：国家科技基础资源调查专项项目,编号2019FY101200;河北省2023年度医学科学研究课题计划项目,编号20231759。

摘　　要：目的:分析某院2018-2021年儿童血流感染病原菌分布及耐药性,为儿科抗菌药物的合理应用提供参考。方法:回顾性分析2018-2021年唐山市妇幼保健院住院患儿的血培养标本,探讨病原菌分布及药物敏感性特征。结果:29 250份血培养标本共检出阳性菌株702例,阳性率为2.40%。革兰阴性菌占比54.99%(386/702),其中最多的为大肠埃希菌19.37%(136/702),其次为肺炎克雷伯菌14.81%(104/702);革兰阳性菌占比44.73%(314/702),其中最多的为肺炎链球菌16.38%(115/702),其次表皮性葡萄球菌10.11%(71/702)。386株革兰阴性菌中,大肠埃希菌对氨苄西林、头孢唑林、头孢呋辛、复方磺胺甲噁唑、四环素和头孢噻肟的耐药率较高,分别为88.97%、84.56%、66.91%、66.18%、63.97%和62.50%,对多黏菌素B敏感;肺炎克雷伯菌对头孢唑林、氨苄西林/舒巴坦、头孢呋辛、莫西沙星、哌拉西林和头孢噻肟的耐药率较高,分别为81.73%、61.54%、61.54%、54.81%、53.85%和51.92%,对多黏菌素B敏感。314株革兰阳性菌中,肺炎链球菌对红霉素、克林霉素和四环素的耐药率较高,分别为97.39%、95.65%和88.70%,对左氧氟沙星、莫西沙星、利奈唑胺、万古霉素、替考拉宁和泰利霉素均敏感;凝固酶阴性葡萄球菌对青霉素、红霉素和苯唑西林的耐药率较高,分别为90.99%、81.98%和72.07%,对利奈唑胺、万古霉素和替考拉宁均敏感。结论:我院血流感染病原菌种类繁多,以大肠埃希菌和肺炎链球菌为主,耐药形势严峻,对革兰阴性菌引起的感染推荐经验治疗药物为头孢他啶或头孢吡肟,对革兰阳性菌引起的感染推荐经验治疗药物为万古霉素、替考拉宁或利奈唑胺。Objective:To analyze the distribution and drug resistance of pathogenic bacteria in bloodstream infections in children of a hospital from 2018 to 2021,so as to provide reference for rational application of antibiotics in pediatrics.Methods:Blood culture samples of hospitalized children were retrospectively studied in Tangshan Maternal and Child Health Hospital from 2018 to 2021.The distribution and drug sensitivity of pathogenic bacteria were analyzed.Results:A total of 702 positive strains were detected in 29,250 blood culture samples,with a positive rate of 2.40%.The proportion of Gram-negative bacteria was 54.99%(386/702),of which Escherichia coli took the lead,totally 19.37%(136/702),followed by Klebsiella pneumoniae of 14.81%(104/702).The proportion of Gram-positive bacteria was 44.73%(314/702),of which Streptococcus pneumoniae was 16.38%(115/702),followed by Staphylococcus epidermidis of 10.11%(71/702).Among 386 Gram-negative strains,the resistance rates of E.coli to ampicillin,cefazolin,cefuroxime,cotrimoxazole,tetracycline and cefotaxime were respectively 88.97%,84.56%,66.91%,66.18%,63.97% and 62.50%,and were sensitive to polymyxin B.The resistance rates of K.pneumoniae to cefzolin,ampicillin/sulbactam,cefuroxime,moxifloxacin,piperacillin and cefotaxime were respectively 81.73%,61.54%,61.54%,54.81%,53.85% and 51.92%,and were sensitive to polymyxin B.Among 314 Gram-positive strains,S.pneumoniae had high resistance rates to erythromycin,clindamycin and tetracycline,which were respectively 97.39%,95.65% and 88.70%,and were sensitive to levofloxacin,moxifloxacin,linezolid,vancomycin,teicolanin and telycin.The resistance rates of coagulase negative Staphylococcus to penicillin G,erythromycin and benzacillin were respectively 90.99%,81.98% and 72.07%,and were sensitive to linezolid,vancomycin and teicolanin.Conclusion:The pathogens of bloodstream infections in our hospital are complex,mainly E.coli and S.pneumoniae,and the drug resistance is severe.For infections induced by Gram-negative bacteria,ceftazidime or

关 键 词：儿童 血流感染 病原菌 耐药性 

分 类 号：R446.5[医药卫生—诊断学]