厦门大学附属第一医院儿科患者血培养分离菌耐药性分析

Analysis on Drug Resistance of Strains in Blood Culture of Children in the First Affiliated Hospital of Xiamen University

目的了解厦门大学附属第一医院儿科患者血培养分离菌的构成及耐药状况。方法回顾性分析2015年至2018年厦门大学附属第一医院儿科患者血培养分离菌构成比及耐药性。结果359位患儿检出388株分离菌,其中革兰阳性菌株214株(55.15%),革兰阴性菌151株(38.92%),真菌23株(5.93%)。革兰阳性菌分离率前3位分别为表皮葡萄球菌、人葡萄球菌、无乳链球菌,革兰阴性菌中分离率第一位是大肠埃希菌,之后是铜绿假单胞菌和肺炎克雷伯菌。葡萄球菌对青霉素、红霉素耐药率高,大肠埃希菌对亚胺培南、美罗培南、头孢替坦耐药菌株少,部分非发酵革兰阴性杆菌对常用碳青霉烯类抗生素有耐药性,铜绿假单胞菌对亚胺培南、美罗培南耐药率分别为53.3%、25.0%。结论厦门大学附属第一医院儿科患者血培养分离菌以表皮葡萄球菌为主,应动态监测血培养阳性微生物和耐药性,重视临床用药的合理化。

Objective To understand the characteristics and drug resistance of strains obtained from patients aged≤14 years.Methods The drug resistance of strains from the children who have positive results of blood culture from 2015 to 2018 was analyzed retrospectively.Results 388 strains in 359 children were selected,including 214 Gram-positive(G+)bacteria(55.15%),151 Gram-negative(G-)bacteria(38.92%)and 23 fungi(5.93%).The top three bacteria of G+bacteria were Staphylococcus epidermidis,Staphylococcus hominis and Streptococcus agalactiae.Escherichia coli was the most common G-bacteria,followed by Pseudomonas aeruginosa and Klebsiella pneumoniae.The resistance rates of Staphylococci to penicillin and erythromycin were high.Few of Escherichia coli strains were resistant to imipenem,meropenem and cefotetan.Some non-fermenting gram-negative bacilli were resistant to common carbapenems,and the resistance rates of Pseudomonas aeruginosa to imipenem and meropenem were 53.33%and 25.00%,respectively.Conclusion The main strain of blood culture in the First Affiliated Hospital of Xiamen University was Staphylococcus epidermidis.We should monitor the distribution and antibiotic resistance of blood culture pathogens,and promote the rational use of medicines.