2012-2014年宜昌城区儿童细菌感染病原菌分布及耐药性分析

Analysis of pathogenic bacteria spectrum and drug resistance of children bacterial infection from 2012 to 2014 in Yichang city

目的了解2012-2014年宜昌城区儿童细菌感染病原菌分布及各病原菌的耐药性变迁情况。方法从LIS系统中收集2012-2014年细菌培养阳性且符合细菌感染特征的病例404例,对培养及药敏试验结果进行回顾性分析。结果 272例患儿血培养中共分离出141株细菌,构成比前5位分别为表皮葡萄球菌46.81%(66/141)、溶血葡萄球菌12.77%(18/141)、洋葱伯克霍尔德菌10.64%(15/141)、大肠埃希菌5.67%(8/141)和肠球菌4.96%(7/141)。132例患儿一般细菌培养共分离出72株细菌,构成比前5位分别为大肠埃希菌33.33%(24/72)、金黄色葡萄球菌11.11%(8/72)、假单胞菌属9.72%(7/72)、肺炎克雷伯菌8.33%(6/72)、肠球菌和溶血葡萄球菌(均为6.94%)(5/72)。耐药率处于前5位分别为青霉素96.33%、哌拉西林84.38%、红霉素82.71%、头孢曲松和头孢呋辛(均为81.25%),统计病例中未发现对万古霉素和泰能耐药的病原菌。结论 2012-2014年宜昌城区儿童病原菌谱主要以革兰阳性凝固酶阴性的葡萄球菌和革兰阴性的大肠埃希菌为主,对普通青霉素类及四代以前头孢类耐药率较高。

Objective To investigate the distribution and drug resistance of pathogenic bacteria in children in Yichang city in recent 2 years. Methods Date information were collected from LIS system in Yichang Central People′s Hospital, and 404 cases in the last 2 years were collected, all cases showed the clinical characteristics of bacterial infection and positive results after bacterial culture. The results of bacterial culture and drug sensitivity test results were retrospectively analyzed.Results 141 strains of bacteria were isolated from 272 cases of children with blood culture. The top five isolated pathogens were Staphylococcus epidermidis（66/141）, Staphylococcus haemolyticus（18/141）, Burkholderia bacteria（15/141）,Escherichia coli（8/141） and Enterococci（7/141）. And 72 strains of bacteria were isolated from 132 cases of common bacteria culture; the top five were Escherichia coli（24/72）, Staphylococcus aureus（8/72）, Pseudomonas sp.（7/72）, Klebsiella pneumoniae（6/72）, Enterococcus and Staphylococcus haemolyticus（5/72）. Drug resistance rate of the top five anitbiotics were Penicillin（96.33%）, Piperacillin（84.38%）, Erythromycin（82.71%）, Ceftriaxone and Cefuroxime（81.25%）. No vancomycin and imipenem resistant pathogenic bacteria were found. Conclusion The main pathogenic bacteria strain in the children with bacterial infection were Gran-positive coagulase negative Staphylococcus, and Gram-negative Escherichia coli of gram negative from 2012 to 2014 in Yichang urban area. The resistant rates to Penicillin and the first four generations Cephalosporin were very high.