2009至2011年南京地区儿童血培养中病原菌的分布及耐药性分析

Distribution and drug resistance of pathogenic bacteria from blood culture of children in Nanjing during 2009-2011

目的了解近3年南京地区儿童血培养中病原菌的分布及耐药趋势。方法对2009年1月至2011年12月南京市儿童医院送检的血培养标本检出菌的分布和药物敏感性试验结果进行回顾性分析。结果14 232例血培养标本中分离出2 489株病原菌,分离率为17.5%,其中革兰阳性菌2 082株,占83.6%,革兰阴性菌344株,占13.8%,真菌63株,占2.6%。革兰阳性菌主要以凝固酶阴性葡萄球菌(CNS)为主,革兰阴性菌检出率较高的为大肠埃希菌。主要革兰阳性菌对万古霉素、环丙沙星、利福平敏感,对青霉素耐药严重。主要革兰阴性菌对亚胺培南、阿米卡星、头孢哌酮-舒巴坦敏感。结论南京地区儿童血培养病原菌主要以革兰阳性菌为主,血培养检出菌耐药情况严重,临床应根据病原菌种类和药物敏感性试验结果合理使用抗菌药物。

Objective To investigate the distribution and drug resistance of pathogenic bacteria from blood culture of children in Nanjing during recent 3 years. Methods The distribution and drug resistance of pathogenic bacteria from blood culture of children in Nanjing Children＇ s Hospital from January 2009 to December 2011 were analyzed retrospectively. Results Totally 2 489 isolates of bacteria were collected from 14 232 blood culture samples. The isolation rate was 17.5%. A total of 2 082 isolates of Gram positive bacteria accounted for 83.6%. Gram negative bacteria and fungi accounted for 13.8% （ 344 isolates） and 2.6% （63 isolates） , respectively. The main of Gram positive bacteria was coagulase negative Staphylococcus （ CNS）, and Escherichia coli was the most part of Gram negative bacteria. Gram positive bacteria were sensitive to vancomyein, ciprofloxacin and rifampicin and resistant to penicillin seriously. Gram negative bacteria were sensitive to imipenem, amikacin and cefoperazone-sulbaetam. Conclusions Gram positive bacteria are the most frequently pathogenic bacteria from blood culture of children in Nanjing. Drug resistance is serious in these isolates. We should recognize the results of drug sensitivity tests and the indication of pathogenic bacteria to use antibiotics reasonably.