住院患儿血标本中病原菌的分布特点及耐药性分析

Analysis on Distribution Characteristics and Drug Resistance of Pathogenic Bacteria Isolated from Blood Culture of Hospitalized Children

目的:分析住院血培养阳性患儿分离病原菌的分布特点及耐药性。方法:收集0~14岁住院患儿血培养阳性标本442例,置于BACTECTMFX全自动血液细菌培养仪中培养,取少量培养物转种血平板和巧克力平板分离病原菌,使用Walk Away 96型全自动细菌鉴定仪对分离病原菌进行细菌鉴定,采用微量稀释法测定分离病原菌对抗生素的敏感性,采用WHONET5. 6软件对病原菌的抗生素敏感实验进行分析。结果:住院血培养阳性患儿血培养主要病原菌依次为凝固酶阴性葡萄球菌(CNS)、大肠埃希菌、克雷伯菌属、金黄色葡萄球菌、其他肠杆菌属;新生儿和婴儿以CNS和大肠埃希菌为主,幼儿以CNS和其他肠杆菌属为主,学龄前期儿童以CNS和金黄色葡萄球菌为主,学龄期儿童以CNS、大肠埃希菌及金黄色葡萄球菌为主;大肠埃希菌和肺炎克雷伯对亚胺培南、美洛培南及厄他培南的敏感率均为100%,且对其他抗生素均有不同程度耐药;非发酵菌对各类抗生素均存在耐药菌株,未检出对利奈唑胺和万古霉素耐药的葡萄球菌和肠球菌属,耐甲氧西林金黄色葡萄球菌(MRSA)和耐甲氧西林的凝固酶阴性葡萄球菌(MRSCNS)的检出率分别为34. 7%和77. 6%。结论:不同年龄段血培养阳性儿童致病菌分布有所不同,病原菌耐药情况较严重,可选择的抗生素有限。

Objective:To investigate the distribution and drug resistance of the pathogenic bacteria isolated from positive blood culture of hospitalized children.Methods:The positive blood culture from children aged 0~14 years was collected in a certain tertiary hospital.The pathogen was isolated by BACTECTMFX automatic blood bacteria culture instrument,a small amount of culture was transferred to blood plate and chocolate plate to isolate the pathogen,the bacteria were identified by Walk Away 96 automatic bacteria identification instrument,the sensitivity of the isolated pathogen to antibiotics was determined by micro-dilution method,and the antibiotic sensitivity experiment was analyzed by WHONET5.6 software.Results:The main pathogenic bacteria were Coagulase Negative staphylococcus(CNS),E.coli,Klebsiella pneumoniae,Staphylococcus aureus,other Enterobacteriaceae in turn.CNS and E.coli were mainly in newborns and infants.CNS and S.aureus were dominant in preschool children,and CNS,E.coli and S.aureus in school-age children.The sensitivity of E.coli and K.pneumoniae to imipenem,meropenem,and epimipenem was 100%with different degrees of resistance to other antibiotics.The non-fermented bacteria are resistant to all kinds of antibiotics.Staphylococcus and enterococci which were resistant to linazolamide and vancomycin were not detected.The detection rates of methicillin-resistant S.aureus(MRSA)and methicillin-resistant coagulase-negative staphylococci(MRSCNS)were 34.7%and 77.6%respectively.Conclusion:The distribution of pathogenic bacteria in children of different ages is different,the drug resistance of pathogenic bacteria is serious,and the available antibiotics are limited.