儿科抗生素使用及常见的细菌耐药监测

The Resistance Monitoring of Antibiotics and Common Bacterial in Pediatrics

目的:研究与分析儿科抗生素使用及常见的细菌耐药监测情况。方法:选取本院2015年1月-2017年11月收治的58例感染性疾病患儿为对象进行研究,回顾性分析其全部的临床资料,统计分析其抗生素使用情况,并对常见细菌耐药情况进行监测。结果:58例患儿对抗生素的使用率为100%,常见细菌分离出50株,其中革兰阴性杆菌26株(52.0%)、革兰阳性球菌24株(48.0%)。常见细菌中,革兰阳性球菌耐药性:对多数抗生素的耐药性,金黄色葡萄球菌>40.0%左右,且其对苯唑西林、复方新诺明、氯霉素等均为>65.0%;对于青霉素的耐药性,金黄色葡萄球菌为94.0%、表皮葡萄球菌为96.0%,其他球菌为51.0%;对于氨苄青霉素耐药性,表皮葡萄球菌>86.0%,且其对四环素为50.0%,而其他则>18.5%;对于头孢他啶的耐药性,乙型溶血性链球菌为11.0%,其他>27.0%。革兰阴性杆菌耐药性:对于头孢唑林、氨苄西林、哌拉西林等所有细菌耐药性均>79.0%;且对氨曲南为27.5%、对头孢吡肟和亚胺培南为7.5%、对头孢噻肟钠为26.0%、对头孢他啶为51.0%;对于氨曲南的耐药性,铜绿假单胞菌和不动杆菌为46.0%,且两者对复方新诺明为64.0%,对氯霉素、庆大霉素、妥布霉素、环丙沙星为27.0%。结论:在临床儿科中应用抗生素的频率较高,而抗生素耐药性较强的主要为呼吸道中分离的革兰阳性/阴性球菌等。

Objective：To study and analyze the use of pediatric antibiotics and the common surveillance of bacterial drug resistance.Method：From January 2015 to November 2017 in our hospital,58 infants with infectious diseases were enrolled in this study.All the clinical data were retrospectively analyzed,their antibiotic use was statistically analyzed,and the common bacterial drug resistance Monitoring.Result：According to statistics,58 cases of children on the use of antibiotics was 100%.Fifty strains were isolated from common bacteria,including 26 strains（52.0%） of Gram-negative bacilli and 24 strains（48.0%）of Gram-positive cocci.In common bacteria,Gram-positivecocci drug resistance： Staphylococcus aureus was more than 40.0% for resistance to most antibiotics;Oxacillin,Cotrimoxazole,Chloramphenicol were more than 65.0%;the resistance to Penicillin was 94.0% for staphylococcus aureus,96.0% for staphylococcus epidermidis,51.0% for other cocci;the resistance of staphylococcus epidermidis to Ampicillin was more than 86.0%,and to Tetracycline was 50.0%,while to the other antibiotics were more than 18.5%;the drug resistance of beta hemolytic streptococcus to Ceftazidime was 11.0%,and to the other antibiotics were more than 27.0%. Gram-negative bacilli drug resistance：allbacteria resistance to Cefazolin,Ampicillin,Piperacillin were more than 79.0%;Aztreonam was 27.5%,Cefepime and Imipenem was 7.5%,Cefotaxime was 26.0%,Ceftazidime was 51.0%;the drug resistance of Pseudomonas aeruginosa and Acinetobacter to Aztreonam were 46.0%,and Cotrimoxazole were 64.0%;Chloramphenicol,Gentamicin,Tobramycin,Ciprofloxacin were 27.0%.Conclusion：There is a high frequency of antibiotics in clinical pediatrics,while the strong antibiotic resistance is mainly Gram-positive/negative cocci isolated in respiratory tract.