儿科重症监护室住院患者感染病原菌分布及药敏分析

The distribution and drug-sensitivity of pathogens detected in hospitalized patients of pediatric intensive care unit

目的了解儿科重症监护室住院患者感染病原菌分布和药敏特点。方法采用WHONET 5.0软件对2019年广东省人民医院儿科重症监护室送检验科微生物室培养的数据进行导出分析。结果2019年儿科重症监护室送检标本中培养出病原菌的数量是194株。分析检出比例占前十的病原菌分布发现,呼吸道标本(包括痰、肺泡灌洗液和纤支镜冲洗液)的检出比例最高,占76.29%(148/194),菌种检出比例最高的是金黄色葡萄球菌,占15.98%(31/194),其次是肺炎克雷伯菌,占13.40%(26/194),铜绿假单胞菌和胞曼不动杆菌分别占11.86%和10.31%。对主要流行菌株的药敏分析发现,肺炎克雷伯菌对氨苄西林/舒巴坦(66.67%)和头孢曲松(58.33%)的耐药率最高,胞曼不动杆菌和铜绿假单胞菌对大部分药物普遍敏感,但对碳青霉烯类药物(美罗培南和亚胺培南)的耐药率偏高,尤其是胞曼不动杆菌。金黄色葡萄球菌对青霉素G耐药率达到96.55%。结论儿科重症监护室的感染以呼吸道感染常见,主要的病原菌为金黄色葡萄球菌、肺炎克雷伯菌、铜绿假单胞菌和胞曼不动杆菌,主要流行菌株对大部分抗菌药物的敏感性较高。

Objective To understand the distribution and drug-sensitivity characteristics of pathogens in pediatric intensive care unit(PICU).Methods The WHONET 5.0 software was used to export and analyze the data of the microbial cultivation from PICU in 2019.Results In 2019,the positive numbers of bacteria culture in PICU were 194 strains.The types of specimens with the highest proportion of the top ten pathogens detected in PICU were respiratory tract specimmens(sputum,bronchoalveolar lavage fluid and bronchoscope rinsing fluid),accounting for 76.29%(148/194).The most frequently detected strain in PICU was Staphylococcus aureus(15.98%,31/194),followed by Klebsiella pneumoniae(13.40%),Pseudomonas aeruginosa(11.86%)and Acinetobacter baumannii(10.31%).According to the drug susceptibility analysis of the main epidemic strains,the drugs with the highest resistance rate for Klebsiella pneumoniae were Ampicillin/sulbactam(66.67%)and ceftriaxone(58.33%).Pseudomonas aeruginosa and Acinetobacter baumannii was generally sensitive to most antibiotics except for carbapenems(meropenem and imipenem),especially Acinetobacter baumannii.The resistance rate of Staphylococcus aureus to penicillin G and oxacillin reached96.55%.Conclusion In pediatric intensive care unit,the most common isolated specimens was respiratory tract samples;the major isolated strains were Staphylococcus aureus,Klebsiella pneumoniae,Pseudomonas aeruginosa and Acinetobacter baumannii,which had high drug sensitivity to most antibacterial drugs.