46例儿童非发酵菌败血症病原菌及耐药性分析

Pathogen and Drug Resistance Analysis of 46 Children with Sepsis Caused by Nonfermenting Bacteria

[目的]探讨儿童感染非发酵茵败血症的病原学及耐药性特点，为临床的正确诊疗提供依据。[方法]对2009年10月至2011年10月本院收治的疑似败血症儿童患者中分离的病原体用天地人200B系统鉴定及药敏试验，并结合临床资料进行分析。[结果]2264份血标本检出需氧茵216株，检出率9．54％；其中革兰阴性杆菌112株，占51．85％，非发酵菌46株，占革兰阴性杆菌的41．07％。非发酵茵以28d至1岁儿童感染率最高（P〈0．01，P〈0．05），1～4岁组次之。非发酵茵对青霉素类和第一、二、三代头孢茵素较耐药，对头孢吡肟敏感率高，对亚胺培南100％敏感。[结论]非发酵茵可引起儿童败血症，耐药率高。亚胺培南、头孢吡肟是非发酵菌感染的首选用药，使用敏感抗生素治疗，防止耐药菌株的产生。

[Objective]To explore the etiology and characteristics of drug resistance of children with sepsis caused by nonfermenting bacteria in order to provide the evidence for correct diagnosis and treatment in clinic. [Methods] The pathogen isolated from children with suspected sepsis treated in our hospital from October 2009 to October 2011 were identified by 200B system. Drug susceptibility test was performed. The clinical da ta combined with etiology were analyzed. [Results] The 216 strains of aerobic bacteria was detected in 2264 blood samples, and the detection rate was 9.54%. Of 216 strains of aerobic bacteria, 112 strains（51.85%） were Gramnegative bacteria and 46 strains（41.07%） were nonfermenting bacteria. The infection rate of non fermenting bacteria in children aged from 28 days to one year old was the highest（ P 〈0.01, P 〈0.05）, and that in children aged 14 years old was the second. Nonfermenting bacteria were more resistant to penicillin and the first, second and third generation of cephalosporins, but their sensitivity to cefepime was the highest, and their sensitivity to imipenem was 100%. [Conclusion] Nonfermenting bacteria can cause sepsis in children and have high drug resistance. Imipenem or cefepime are the preferred drugs for nonfermenting bacteria infec tion. Sensitive antibiotics should be used to prevent the emergence of drugresistant strains