2017年广东省东莞地区儿童血培养病原菌分布及耐药性分析

Analysis of Pathogen Distribution and Drug Resistancein Blood Culture of Children in Dongguan Area

目的了解广东省东莞地区儿童患者血培养病原菌临床分布和耐药性情况。方法对2017年1～12月东莞市23家二级甲等及以上参加细菌耐药监测的医疗机构的住院儿童患者血培养病原菌分布和耐药性进行回顾性分析。结果广东省东莞地区儿童患者血培养全年共分离病原菌979株,其中革兰阳性菌541株(占55.26%),前三位病原菌为凝固酶阴性葡萄球菌(CNS)、金黄色葡萄球菌和肺炎链球菌,分别占41.98%,3.57%和2.86%;革兰阴性菌431株(占44.02%),前三位病原菌为黏质沙雷菌、大肠埃希菌和斯氏假单胞菌,分别占13.68%,11.44%和5.31%;真菌7株(占0.72%)。药敏结果显示革兰阳性葡萄球菌对青霉素和氨苄西林耐药率高,SCN耐药严重;革兰阴性杆菌对氨苄西林耐药严重,头孢哌酮/舒巴坦、哌拉西林/他唑巴坦和碳青霉烯类敏感率较高。结论广东省东莞地区儿童血培养以革兰阳性球菌为主,其中SCN占优势且耐药严重。应加强对儿童患者血培养病原菌的耐药性监测,掌握其耐药特点以有效控制感染并减少多重耐药菌的产生。

Objective To understand the clinical distribution and drug resistance of pathogen in blood culture of children in Dongguan Area of Guangdong Province.Methods The pathogen in blood culture of children isolated from hospitalized patients in 23 secondary and above medical institutions which participated in bacterial monitoring in Dongguan from January2017 to December 2017 were retrospectively analyzed.Resules A total of 979 strains of pathogenic bacteria were isolated from the blood cultures of children in the whole year in Dongguan,including 541 strains of gram-positive bacteria(55.26%).The top three pathogens were coagulase-negative Staphylococcus(CNS),Staphylococcus aureus and Streptococcus pneumoniae,accounted for 41.98%,3.57%and 2.86%respectively.431 strains of gram-negative bacilli(44.02%).The top three pathogens were Serratia marcescens,Escherichia coli and Pseudomonas stutzeri,accounted for 13.68%,11.44%and 5.31%respectively,and 7 strains of fungi(0.72%).Drug sensitivity test showed that the drug resistance rates of grampositive Staphylococcus to penicillin and ampicillin was higher.Coagulase-negative Saphylococcus drug esistance was serious.Gram-negative bacilli was highly resistant to ampicillin.The sensitivity rates of cefoperazone/sulbatam,piperacillin/tazobactam and carbapenem were higher.Conclusion The blood cultures of children were mainly gram-positive cocci in dongguan.The coagulase-negative Staphylococcus was dominant and the drug resistance was serious.We should strengthen the monitoring of drug resistance of the isolated from blood samples in order to take effective measures to control and prevent the emergence of multidrug resistance.