摘要
目的了解败血症患儿感染产AmpC酶细菌的耐药及基因型,为临床治疗提供指导。方法对2009年1月-2011年1月湖南省儿童医院收治的败血症患儿中分离的病原体用VITEK-2Compact进行鉴定和药敏试验,并进行AmpC/R及DHA基因检测。结果10 264份血标本中检出革兰阴性杆菌581株,占总检出菌的59.77%,其中的56株人苍白杆菌及22株肺炎克雷伯菌对氨苄西林、头孢一、二、三代、氨曲南等耐药率较高,对头孢吡肟、亚胺培南、环丙沙星敏感率较高;基因检测显示,人苍白杆菌有ampC/R基因,肺炎克雷伯菌有DHA型AmpC酶。结论人苍白杆菌及肺炎克雷伯菌可导致婴幼儿败血症,头孢吡肟是首选药物,重症患儿可用亚胺培南;加强抗菌药物使用的控制,防止更多的耐药基因在菌种中传播。
OBJECTIVE To investigate the drug resistance and the genotypes of AmpC-producing bacteria causing infections in the children with septicemia so as to guide the clinical treatment.METHODS The bacterial identification and drug susceptibility testing were performed with VITEK-2 Compact for the pathogens isolated from the children with septicemia who were treated in Hunan Children′s Hospital from Jan 2009 to Jan 2011,then the AmpC/R and DHA genes were detected.RESULTS A total of 581 strains of gram-negative bacilli were isolated from 10 264 blood samples,accounting for 59.77%.There were 56 strains of Ochrobactrum anthropi and 22 strains of Klebsiella pneumoniae,whose drug resistance rates to ampicillin,the first,second,and third generation of cephalosporins,and aztreonam were relatively high,the drug susceptibility rates to cefepime,ciprofloxacin,and imipenem were relatively high.The gene test showed that O.anthropi carried with AmpC/R genes and K.pneumoniae produced DHA AmpC.CONCLUSION O.anthropiand K.pneumoniae can cause the septicemia in the infants.The cefepime can be used as the preferred antibiotics,and imipenem is used for the children critically ill.The control of the antibiotics application should be strengthened to prevent the spread of the drug resistant genes through those strains.
出处
《中华医院感染学杂志》
CAS
CSCD
北大核心
2012年第24期5452-5454,共3页
Chinese Journal of Nosocomiology
基金
湖南省科技厅一般科技计划(2009sk3047)
