2011-2012年我院14岁以下患儿病原菌分布特点的临床调研

Clinical Investigation on Distribution Features of Pathogenic Bacteria in Patients under Age 14 in Our Hospital during 2011-2012

目的:为临床医师经验性使用抗菌药物提供一定的依据。方法:收集2011-2012年我院所有14岁以下住院患儿的病原学检测结果,按照病原菌种类、送检标本种类以及不同感染部位等对病原菌分布特点进行分析。结果:2011-2012年病原菌总数构成比为革兰阴性(G-)菌62.35%,革兰阳性菌37.65%;临床科室送检率较高的标本分别为痰液、尿液、血液,而细菌检出率较高的标本分别为分泌物、胸腹水、痰液;患者居住地为县级以上及县级以下病例的耐药率分别为61.36%、59.89%,多重耐药率分别为35.08%、34.65%;内科、外科检出率较高的均为G-菌,多重耐药率分别为21.95%、37.50%;不同感染部位、不同年龄阶段的患者病原菌分布具有相应的分布特点。结论:我院14岁以下住院患儿病原菌构成比与多数文献报道一致;分析得出的细菌检出率、多重耐药菌的耐药率以及不同感染部位的病原菌特点,可为临床经验性使用抗菌药物提供科学依据。

OBJECTIVE： To provide evidence for physicians to use antibiotics empirically. METHODS： The results of pathogen- ic bacteria test in the inpatients under age 14 were collected from our hospital during 2011- 2012. The distribution features of patho- genic bacteria were analyzed according to varieties of pathogenic bacteria, varieties of specimen and infection site. RESULTS ： The constituent ratio of pathogenic bacteria during 2011- 2012, Gram-negative （G-） bacteria accounted for 62.35%, and Gram-positive bacterial （G＋） for 37.65%. The detection rate of sputum, urine and blood were higher than other specimen in clinical departments. The pathogenic bacteria were detected frequently in sputum, pleural and urine. The rate of drug resistance in country-level above or below were 61.36% and 59.89%, and the rates of multi-resistance were 35.08% and 34.65%, respectively. G- bacteria were detect- ed frequently both in medicine department and surgery department, and the rates of multi-resistance was 21.95% and 37.50% respec- tively. The distribution features of pathogenic bacteria were different among different infectious sites and age groups. CONCLU- SIONS： The constituent ratio of pathogenic bacteria in the inpatients under age 14 in our hospital are matched with the most pub- lished literature. The figures for detection rate, drug resistance of multi-resistance bacterial and pathogenic bacteria of different infec- tious sites offer clinical evidence for empirical use of antibiotics.