2020年山东大学齐鲁儿童医院患者病原菌及耐药特征分析

Analysis on pathogenic bacteria and drug resistance characteristics of patients in Qilu Children's Hospital of Shandong University,2020

目的了解2020年山东大学齐鲁儿童医院入院儿童患者病原菌分布及耐药特征,为合理使用抗菌药物提供数据支持。方法收集2020年1-12月该院儿童患者的临床样本33737份,使用微生物鉴定分析仪判定病原菌种类,并使用Microscan Walkaway 96Plus仪器及纸片扩散法对病原菌进行药敏检测,依据2020年CLSI M100-S26判定。结果33737份临床样本中病原菌检出率为16.10%。革兰氏阴性菌株占69.19%,革兰氏阳性菌株占28.12%,真菌菌株占2.69%。占比前5位病原菌为肺炎克雷伯杆菌、金黄色葡萄球菌、大肠埃希菌、鲍曼不动杆菌及铜绿假单胞菌,分别为14.64%、14.53%、12.38%、11.33%和8.12%。其中,肺炎克雷伯杆菌和大肠埃希菌对第三代头孢菌素的耐药率较高,对碳青霉烯类抗菌药物耐药率较低;未发现金黄色葡萄球菌对万古霉素、利奈唑胺耐药,对青霉素G的耐药率为95.67%。结论该院儿童患者病原菌以革兰氏阴性菌为主,其中肺炎克雷伯杆菌和大肠埃希菌对第三代头孢菌素类抗菌药物有较高的耐药率,对碳青霉烯类抗菌药物耐药率较低;革兰氏阳性菌中金黄色葡萄球菌对万古霉素及利奈唑胺耐药率较低,对青霉素类抗菌药物的耐药性较高。

Objective To understand the distribution of pathogenic bacteria and drug resistance characteristics in patients admitted to Qilu Children's Hospital of Shandong University in 2020,so as to provide data support for the rational use of antibiotics by patients.Methods A total of 33737clinical samples were collected from pediatric patients in the hospital from January to December 2020.The pathogenic bacteria were determined by using microbial identification analyzer,and the drug sensitivity of the pathogenic bacteria was tested by using Microscan Walkaway 96Plus instrument and disk diffusion method according to the judgment of CLSI M100-S26in 2020.Results A total of 33737samples were collected,and the detection rate of pathogenic bacteria was 16.10%.Gram-negative strains accounted for 69.19%,Gram-positive strains accounted for 28.12%,and fungal strains accounted for 2.69%.The top 5pathogens were Klebsiella pneumoniae,Staphylococcus aureus,Escherichia coli,Acinetobacter baumannii and Pseudomonas aeruginosa,accounting for 14.64%,14.53%,12.38%,11.33%and 8.12%.Among them,Klebsiella pneumoniae and Escherichia coli had a higher resistance rate to third-generation cephalosporins,and a lower resistance rate to carbapenems.Staphylococcus aureus was not found to be resistant to vancomycin and linezolid,and the drug resistance rate to penicillin G was 95.67%.Conclusion The pathogenic bacteria in children patients in the hospital are mainly Gram-negative bacteria.Among them,Klebsiella pneumoniae and Escherichia coli have higher resistance rate to third-generation cephalosporins,but lower resistance rates to carbapenems.Among the Gram-positive bacteria,Staphylococcus aureus has a low resistance rate to vancomycin and linezolid,and a high resistance rate to penicillin antibiotics.