德阳地区败血症患儿血培养阳性结果及药敏特点分析

Analysis of Blood Culture Positive Results and Drug Sensitivity of Children with Sepsis in Deyang Area

目的分析德阳地区败血症患儿血培养阳性的病原菌分布及药敏特点。方法对德阳市人民医院2017年1月至2019年12月新生儿科和儿科收治的90例败血症患儿的血培养病原菌检测结果和药敏实验结果进行回顾性分析。结果 90例血培养阳性检出病原菌分布为革兰氏阳性菌53株(58.89%),革兰氏阴性菌37株(41.11%)。其中革兰氏阳性菌检出率较高的为肺炎链球菌、表皮葡萄球菌及溶血葡萄球菌,革兰氏阴性菌检出率较高的为大肠埃希菌和肺炎克雷伯菌。按不同年龄段统计,≤3个月患儿检出病原菌55株,检出率最高的为大肠埃希菌;>3个月患儿检出病原菌35株,检出率最高的为肺炎链球菌。葡萄球菌属主要对红霉素、克林霉素、青霉素耐药;链球菌属主要对红霉素和青霉素耐药;两菌属对左氧氟沙星、万古霉素和利奈唑胺敏感。大肠埃希菌主要对青霉素类抗菌药物耐药性较高,对碳青霉烯类均敏感。结论不同年龄段引起败血症的病原菌分布不同,可指导早期治疗的经验性用药;针对败血症患儿应早期开展血培养检查,根据病原菌及药敏结果合理选择抗菌药物。

Objective To analyze the distribution and drug sensitivity of pathogens in children with sepsis in Deyang area.Methods The blood culture pathogen detection results and drug sensitivity test results of 90 children with sepsis admitted to the Department of Neonatology and pediatrics in Deyang people’s Hospital from January 2017 to December 2019 were retrospectively analyzed.Results Fifty three strains (58.89%) of Gram-positive bacteria and 37 strains (41.11%) of Gram-negative bacteria were detected in 90 cases of blood culture.Streptococcus pneumoniae,Staphylococcus epidermidis and Staphylococcus haemolyticus had higher detection rate of Gram-positive bacteria,while Escherichia coli and Klebsiella pneumoniae had higher detection rate of Gram-negative bacteria.According to the statistics of different age groups,55 strains of pathogenic bacteria were detected in children ≤ 3 months,Escherichia coli had the highest detection rate,35 strains were detected in children > 3 months,and the highest detection rate was Streptococcus pneumoniae.Staphylococcus is mainly resistant to erythromycin,clindamycin and penicillin.Streptococcus is mainly resistant to erythromycin and penicillin;the two genera are sensitive to levofloxacin,vancomycin and linezolid.Escherichia coli was mainly resistant to penicillins and sensitive to carbapenems.Conclusion The distribution of pathogens causing sepsis in different age groups was different,which can guide the empirical medication for early treatment.Blood culture examination should be carried out early for septicemia children,and antibiotics should be selected reasonably according to the results of pathogenic bacteria and drug sensitivity.