儿童感染性疾病病原菌分布及耐药性分析

Distribution and drug resistance of pathogens causing infectious diseases in children

目的分析儿童感染性疾病病原菌分布及耐药性,为儿童抗菌药物的合理使用提供参考。方法对2013年1-12月儿科感染性疾病患儿各类送检标本进行培养,统计分析其病原菌分布及耐药性。结果 5 884份标本中共检出病原菌812株,阳性率为13.8%;其中革兰阴性菌552株,占67.98%,革兰阳性菌259株,占32.02%;排名前5位的病原菌依次为大肠埃希菌、肺炎克雷伯菌、金黄色葡萄球菌、肺炎链球菌和流感嗜血菌,检出率分别为20.81%、16.87%、14.29%、11.33%和7.15%;大肠埃希菌和肺炎克雷伯菌产ESBLs菌的检出率分别为56.44%和23.64%,未检出耐碳青霉烯类大肠埃希菌,少量肺炎克雷伯菌显示对碳青霉烯耐药;金黄色葡萄球菌中MRSA的检出率为13.91%,未发现耐万古霉素金黄色葡萄球菌。结论患儿检出病原菌对常用抗菌药物有不同程度的耐药,应根据药敏结果合理选用抗菌药物。

OBJECTIVE To analyze the distribution and drug resistance of pathogens causing infectious diseases in children so as to provide guidance for reasonable use of antibiotics .METHODS From Jan 2013 to Dec 2013 ,the submitted specimens collected from the children with infectious diseases in department of pediatrics were cultured , then the distribution and drug resistance of the pathogens were statistically analyzed .RESULTS A total of 812 strains of pathogens have been isolated from 5 884 specimens ,with the positive rate of 13 .8% ;there were 552 （67 .98% ） strains of gram-negative bacteria and 259 （32 .02% ） strains of gram-positive bacteria;the Escherichia coli ,Klebsiella pneumoniae ,Staphylococcus aureus ,Streptococcus pneumoniae ,and Haemophilus influenzae ranked the top five species of pathogens ,the detection rates of which were 20 .81% ,16 .87% ,14 .29% ,11 .33% , and 7 .15% ,respectively .The detection rates of the ESBLs-producing E .coli and K .pneumoniae were 56 .44%and 23 .64% ,respectively ;the carbapenem-resistant E .coli strains were not detected ,and few K .pneumoniae strains showed resistance to carbapenems ;the detection rate of MRSA was 13 .91% among the S .aureus strains , and the vancomycin-resistant S .aureus was not detected .CONCLUSIONS The pathogens isolated from the children with infectious diseases vary in the drug resistance to the commonly used antibiotics ,and it is necessary to reasonably use antibiotics based on the results of drug susceptibility testing .