儿童血培养病原菌分布及耐药性分析

Bacterial profile and antimicrobial susceptibility pattern in blood samples of children

目的：了解患儿近5年血培养病原菌分布及耐药情况。方法无菌采集患儿血液标本，37℃培养7 d ，采用血平板和巧克力平板转种病原菌，采用自动微生物鉴定仪对病原菌进行鉴定和药敏实验。结果2009～2013年共送检36636份血培养标本，检出病原菌2107株，阳性率为5．75％。其中，革兰阳性菌1413株（占67．06％）、革兰阴性菌626株（占29．71％）、真菌68株（占3．23％）。主要的分离菌为凝固酶阴性葡萄球菌（44．03％），其次是大肠埃希菌（9．33％）、金黄色葡萄球菌（6．46％）、肺炎克雷伯菌（5．74％）和肠球菌属（4．94％）。大部分革兰阴性菌对氨苄西林耐药，大部分革兰阳性菌对青霉素耐药。结论革兰阳性球菌是该院患儿血培养的主要病原菌。大部分病原菌对常用抗菌药物耐药率较高。

Objective To assess the prevalence of bacterial isolates from septicemia suspected pediatric patients and antimicrobial susceptibility pattern .Methods Blood was collected with aseptic precaution and incubated at 37 ℃ for 7 days .Subcultures were made on blood agar and chocolate agar plates .Organisms were identified and antibiotic sensitivity test of the isolates were performed by automatic microbiology system .Results From 2009 to 2013 ,36 636 blood culture were detected ,from which 2 107 strains of pathogenic bacteria were isolated ,and the positive rate was 5 .75% .The rates of Gram‐positive bacteria ,Gram‐negative bacteria and fungi were 67 .06% （1 413 isolates） ,29 .71% （626 isolates）and 3 .23% （68 isolates） ,respectively .The predominant bacteria were coagulase negative staphylococci （44 .03% ） ,followed by E .coli （9 .31% ） ,S .aureus （6 .46% ） ,K .spp （5 .75% ） and Enterococcus （4 .94% ） .Most of Gram‐negative organisms were highly resistant to ampicillin ,and Gram‐positive organisms were highly resistant to penicillin .Conclusion Gram‐positive cocci could be the main pathogens in blood culture of pediatric patients .Pathogens isolated from blood might be with high resistance rate to most commonly used antibiotics .