2018年-2021年陕西某医院儿童血流感染病原菌分布及耐药分析

Distribution and antibiotic resistance of bacteria isolated from blood culture in a hospital in Shaanxi Province,2018-2021

目的 分析陕西某妇儿医院儿童血流感染病原菌分布及其对常见抗生素的耐药分析。方法 回顾性分析了2018年—2021年西北妇女儿童医院儿童血培养分离的病原菌及其药物敏感性。结果 共分离病原菌1 102株,革兰阳性菌占比52.36%,革兰阴性菌占比46.91%。前5位的病原菌依次为凝固酶阴性的葡萄球菌(CNS,41.37%)、木糖氧化无色杆菌(15.43%)、嗜麦芽窄食单胞菌(8.98%)、大肠埃希菌(7.17%)和海水盐单胞菌(6.44%)。甲氧西林耐药的凝固酶阴性的葡萄球菌(MRCNS)占CNS的84.4%。木糖氧化无色杆菌、嗜麦芽窄食单胞菌、海水盐单胞菌对药敏试验的抗生素敏感度较高。耐碳青霉烯酶肠杆菌(CRE)肺炎克雷伯检出率(4.4%)高于大肠埃希菌(1.3%)。结论 西北妇女儿童医院儿童血流感染主要病原菌为CNS和非发酵菌。应合理使用抗菌药物,减少多重耐药菌的产生。注意操作的规范性,降低定植菌和条件致病菌在院内的传播。

Objective This paper aims to analyze the characteristics and drug resistance of pathogenic bacteria of children with bloodstream infection in Northwest Women and Children's Hospital.Methods Pathogenic bacteria isolated from children's blood culture in Northwest Women and Children's Hospital from 2018 to 2021 and their drug sensitivity were retrospectively analyzed.Results A total of 1 102 strains of pathogenic bacteria were isolated,with Gram-positive bacteria accounting for 52.36% and Gram-negative bacteria accounting for 46.91%.The top 5 pathogenic bacteria were coagulase negative Staphylococcus(CNS,41.37%),Achromobacter xyloxis(15.43%),Stenotrophomonas maltophil(8.98%),Escherichia coli(7.17%) and Halomonas salina(6.44%).Methicillin-resistant coagulase negative Staphylococcus(MRCNS) accounted for 84.4% of the CNS.Achromobacter xyloxacin,Stenotrophomonas maltophilia and Halomonas salinae were highly sensitive to antibiotics in the drug sensitivity test.The detection rate of carbapenemase resistant Enterobacter(CRE) was higher(4.4%) than that of Escherichia coli(1.3%).Conclusion CNS and non-fermentation bacteria are the main strains of children with bloodstream infection in Northwest Women and Children's Hospital.Antibiotics should be used rationally to reduce the generation of multi-drug resistant bacteria.Attention should be paid to the normalization of operation so as to reduce the nosocomial spread of colonization bacteria and opportunistic bacteria.