摘要
目的：调查近10年于汕头市中心医院就诊的血流感染患儿致病菌的分布及耐药情况。方法收集2006至2015年汕头市中心医院符合血流感染诊断标准且双份不同部位血培养为相同菌株的住院患儿，分析其病原菌及对抗菌药物的耐药情况。结果入选的327例共检出菌株327株，革兰阳性菌占40.67％，革兰阴性菌占58.41％，真菌占0.92％。前5年（2006至2010年）与后5年（2011至2015年）血流感染常见病原菌比较差异无统计学意义（P ＞0.05），但无乳链球菌感染有上升趋势（χ2＝5.205，P ＝0.023）。新生儿以肺炎克雷伯菌及大肠埃希菌为主，婴儿以金黄色葡萄球菌为主，1～5岁以肺炎链球菌为主。药敏试验显示，39.13％金黄色葡萄球菌对苯唑西林耐药，未检出万古霉素耐药株；68.75％肺炎链球菌对青霉素耐药，而无乳链球菌对青霉素100％敏感；45.90％大肠埃希菌和52.81％肺炎克雷伯菌对头孢曲松耐药。结论该院血流感染患儿不同年龄段致病菌分布不尽相同，且对目前常用抗菌药物存在着严重的耐药性。
Objective To investigate the distribution and drug resistance of pathogens in children with bloodstream infection admitted to Shantou Central Hospital between 2006 and 2015. Methods In a retro-spective study between 2006 and 2015 , the children with bloodstream infection were enrolled if they met the inclusion criteria： diagnosed with bloodstream infection according to the national diagnostic criteria; the same pathogen was isolated from the blood samples collected from two separate sites. The causative pathogens and their drug resistance were analyzed. Results A total of 327 strains of pathogens were isolated from 327 cases including 40. 67% of Gram-positive bacteria, 58. 41 % of Gramnegative bacteria and 0. 92% of fungi. Be-tween the period of 2006 to 2010 and that of 2011 to 2015 , the distribution of common pathogens in children with bloodstream infection did not significantly differ （ P 〉 0. 05 ） , whereas the infection rate of Streptococcus agalactiae tended to increase （X^2 = 5 . 2 0 5 , P =0. 023 ） . Klebsiellar pneumonia and Escherichia coli were the main pathogens for the newborns, Staphycococcus aureus for the infants and Streptococcus pneumoniae for those aged 1 to 5 years. According to the drug resistance analysis, 39. 13% of Staphycococcus aureus was resistant to oxacillin and no vancomycin resistance was found. 68. 75% of Streptococcus pneumonia was resistant to penicillin, whereas 100% of Streptococcus agalactiae was sensitive to penicillin. 45. 90% of Escherichia coli and 52. 81% of Klebsiellar pneumonia were resistant to ceftriaxone. Conclusion The distribution of pathogens significantly differs among pediatric patients of different ages admitted to this hospital. The pathogens are highly resistant to common antibiotic drugs.
出处
《新医学》
2016年第11期752-760,共9页
Journal of New Medicine
基金
国家自然科学基金面上项目(81470219)
广东省公益研究与能力建设专项资金(2014A020212120)
关键词
血流感染
病原菌
耐药性
抗菌药物
儿童
Bloodstream infection
Pathogen
Drug resistance
Antibiotic drug
Child
