2010—2013年百色市人民医院儿科患者感染病原菌的分布与耐药性分析

Clinical analysis on pathogenic bacteria distribution and drug resistance in pediatric department of Baise City People's Hospital from 2010 to 2013

目的明确广西百色市人民医院儿科住院患者感染病原菌的分布及常见病原菌的耐药趋势,为指导临床合理使用抗菌药物和减少耐药性提供可靠依据。方法收集2010—2013年儿科住院患者的各类临床标本,对所分离的病原菌分布及其耐药情况进行回顾性研究分析。结果 4年间送检标本4 582份中共分离出3 139株病原菌,检出率为68.51%。感染的优势菌为凝固酶阴性葡萄球菌703株(22.40%),金黄色葡萄球菌573株(18.25%),大肠埃希菌590株(18.80%),肺炎克雷伯菌406株(12.93%),铜绿假单胞菌229株(7.30%);大肠埃希菌和肺炎克雷伯菌超广谱β-内酰胺酶(ESBLs)的平均检出率分别为63.15%、33.92%。药敏试验结果显示葡萄球菌对青霉素和红霉素的耐药率≥76.61%,但是对万古霉素、利福平和利奈唑胺均敏感;肺炎克雷伯菌、铜绿假单胞菌和大肠埃希菌对碳青霉烯类抗菌药物高度耐药。结论目前儿科主要致病菌对临床常用抗菌药物有不同程度的耐药,因此临床上应重视监测病原菌的分布及耐药趋势,根据药敏结果合理选择抗生素,减少耐药菌株的产生。

Objective To investigate the distribution of pathogenic bacteria and drug resistance in pediatric department, and to provide the certain reference for directing the clinical medication and reducing drug resistance. Methods Various clinical specimens of inpatients in pediatric department from 2010 to 2013 were collected, and the distribution and drug resistance of pathogenic bacteria were retrospectively analyzed. Results A total of 3 139 strains of pathogenic bacteria were isolated from 4 582 specimens with the detection rate of 68.51% in 4 years. The advantage bacterium infection were 703 strains of coagulase negative Staphylococcus （22.40%）, 573 strains of Staphylococcus aureus （18.25%）, 590 strains of Escherichia coli （18.80%）, 406 strains of Klebsiella pneumonia （12.93%）, and 229 strains of Pseudomonas aeruginosa （7.30%）. The average detection rates of extended spectrum β lactamases （ESBLs） from E. coli and K. pneumonia were 63.15% and 33.92%, respectively. Drug sensitivity test showed that S. aureus was resistant to penicillin with the erythromycin resistance rate ≥ 76.61%, but was sensitive to vancomycin, rifampin, and linezolid; Ko pneumoniae, P aeruginosa, and E. coli were highly resistant to antimicrobial drug of carbapenems. Conclusion At present the main species of pathogenic bacteria in pediatric department were resistant to the commomly used antibiotics, so attention should be paid to the distribution and drug resistance of pathogenic bacteria in clinic. In order to reduce the occurrence of drug resistance strains, sensitive antibiotics are chosen aoDrolariatelv according to the results of drug sensitivity test.