儿童创面感染病原菌及β-内酰胺酶表型分析

Investigation and analysis of children wound infected pathogens and its β-lactamase phenotype

目的了解儿童创面感染病原菌构成及耐药情况,指导临床用药。方法对2008年1月～2009年10月该院收治的156例疑为创面感染患儿,取创面或伤口拭子进行需氧培养,用VITEK 2com pact进行病原菌鉴定、药敏试验和抗菌药物耐药表型检测。方法 156份标本共检出病原菌111株,阳性率71.15%。其中革兰阳性球菌87株,革兰阴性杆菌24株,主要是金黄色葡萄球菌、表皮葡萄球菌、溶血葡萄球菌、屎肠球菌、肺炎克雷伯菌、铜绿假单胞菌等。葡萄球菌中共检出MRS23株,MRSA6株,革兰阴性杆菌中检出产ESBLs菌7株。革兰阳性球菌对青霉素、氨苄西林、红霉素耐药率高。革兰阴性杆菌对对氨苄西林、头孢唑啉等耐药率高,对亚胺培南、哌啦西林/他唑巴坦、左氧氟沙星敏感。结论儿童创面感染以金黄色葡萄球菌为主。加强微生物学检测,防止耐药菌株的产生。

[ Objective ] To investigate children wound infection and drug resistance of pathogens, aim to guide clinical treatment. [Methods] 156 patients who suspected wound infection in our hospital from January 2008 to October 2009, wound or wound swab taken for aerobic culture, the bacteria antibiotics susceptibility testing and phenotypic testing with VITEK2 compact system identification. [Results] A total of 156 specimens, 111 strains isolated pathogens positive, the positive rate of 71.15%, 87 strains of Gram-positive, 24 strains of Gram-negative bacteria, mainly of them are Staphylococcus aureus, Staphylococcus epidetmidis, Staphylococcus haemolyticus, feces Entero- coccus, Klebsiella pneumoniae, Pseudomonas aeruginosa, and so on. MRS 23 strains, MRSA 6 strains were detected from the Staphylococcus. ~Seven strains of ESBLs producing bacteria were detected in Gram-negative bacilli. Grampositive coccus with higher resistance rate to penicillin, ampicillin, erythromycin. It is high resistant rate of Gram- negative bacilli to ampicillin, eefazolin, sensitive to imipenem, piperacillin/tazobactam, and levofloxacin. [ Conclu- sion ] Accounted for in the children wound infection Staphylococcus aureus is the mainly pathogens. Strengthen the microbiology testing, prevention of drug-resistant strains produced.