儿童感染患者标本中苛养菌的检出率及其耐药性分析

Detection rate and drug resistance of caustic bacteria in children’s specimens

目的分析本院儿童患者标本中苛养菌的分离率及耐药情况,为儿科感染的经验用药提供依据。方法收集本院2016年-2018年儿童患者分离的病原菌762株,采用全自动细菌鉴定仪VITEK 2 Compact及ATB HAEMO试剂条进行鉴定和药敏试验。结果共分离苛养菌145株(19.0%),流感嗜血杆菌(6.8%)和肺炎链球菌(6.4%)最多,主要来源于呼吸道标本(88.9%)。肺炎链球菌和化脓性链球菌对利奈唑胺、万古霉素、左氧氟沙星及氯霉素的敏感度均>90%;对四环素、克林霉素、红霉素的耐药率均>90%。肺炎链球菌对青霉素类和头孢类抗生素的敏感度(50%~80%)低于化脓性链球菌(100.0%)。流感嗜血杆菌的β-内酰胺酶检出率为44.2%,对利福平、氯霉素、四环素、左氧氟沙星、头孢噻肟的敏感度均>80%。卡他莫拉菌对阿莫西林/克拉维酸、利福平、氯霉素、四环素、左氧氟沙星、头孢噻肟、头孢呋辛的敏感度均>85%。结论儿童患者病原菌中苛养菌占比较高,明显高于成人,且具有独特的耐药谱,因此儿科医生需重视儿童患者苛养菌的检出及药敏情况。

Objective To analyze the isolation rate and drug resistance of caustic bacteria from children in Shengzhou Hospital of Traditional Chinese Medicine,so as to provide basis for experiential medication of pediatric infections.Methods 762 strains of pathogenic bacteria isolated from children in our hospital during 2016-2018 were identified and tested by VITEK-2 Compact and ATB HAEMO.Results A total of 145 strains of caustic bacteria(19.0%)were isolated from the clinical specimens of children in our hospital.Haemophilus influenzae and Streptococcus pneumoniae accounted for 6.8% and 6.4%of the total pathogens,mainly from respiratory tract specimens(88.9%).The sensitivity of Streptococcus pneumoniae and Streptococcus pyogenes to linezolid,vancomycin,levofloxacin and chloramphenicol was more than 90%,and the resistance rate to tetracycline,clindamycin and erythromycin was more than 90%.The sensitivity of S.pneumoniae to penicillin and cephalosporin antibiotics(50%-80%)was lower than that of S.pyogenes(100.0%).The detection rate of beta-lactamase in Haemophilus influenzae was 44.2%.The sensitivity to rifampicin,chloramphenicol,tetracycline,levofloxacin and cefotaxime was all over 80%.The susceptibility of Moraxella catarrhalis to amoxicillin/clavulanic acid,rifampicin,chloramphenicol,tetracycline,levofloxacin,cefotaxime and cefuroxime was all more than 85%.Conclusion The proportion of caustic bacteria in children is higher than that in adults,so pediatricians should pay attention to the detection of caustic bacteria and the drug sensitivity in pediatric patients.