摘要
目的 研究儿童髋化脓性关节炎病原体及其药物敏感状况.方法 应用抗生素治疗前,在无菌操作下抽取患者脓液进行细菌培养,使用全自动细菌鉴定/药敏系统鉴定菌落与分析药物敏感.结果 分离出的68株阳性病原菌中包含42株革兰氏阳性菌、23株革兰氏阴性菌和3株真菌.对于不同年龄阶段患儿(5天~13岁),髋化脓性关节炎细菌种类存在差异,其中新生儿(<1月)最常见致病菌为肺炎克雷伯氏菌,其他年龄段患儿(1月~13岁)以金黄色葡萄球菌最多见.药物敏感测试结果表明,革兰氏阳性菌均对万古霉素、替考拉宁及利奈唑胺高度敏感;金黄色葡萄球菌对青霉素的耐药性最高,达96%;肺炎克雷伯杆菌、大肠埃希菌、流感嗜血杆菌、阴沟肠杆菌、沙门氏菌某些种对美罗培南和亚胺培南高度敏感.结论 在应用抗菌药物治疗儿童髋化脓性关节炎时,应注意留取病原学标本进行药物敏感分析.没有获得药物敏感分析结果时应行经验用药,待获得可靠的病原学诊断及药物敏感分析结果后改用敏感药物治疗,同时需考虑年龄情况有针对性的用药.
Objective To study the pathogens and their drug susceptibility of septic arthritis of hip in children. Methods Prior to the antibiotic treatment, pus was extracted for bacterial culture under aseptic operation. The pathogenic bacterium was identified and drug susceptibility was analyzed using a fully automated bacterial identification/drug susceptibility system. Results A total of 68 pathogens were isolated, in which 42 were Gram-positive bacteria, 23 were Gram-negative bacteria and 3 were fungi. The results showed differences in the bacterial types of hip septic arthritis in children with different ages (5 days to 13 years). For newborns (less than 1 month), the most common pathogen was Klebsiella pneumoniae; for the ages of 1 month to 13 years old, the most common pathogen was Staphylococcus aureus. The results of drug susceptibility tests showed that Gram-positive bacteria were highly susceptible to vancomycin, teicoplanin and linezolid;the resistance of Staphylococcus aureus to penicillin was up to 96%; and Klebsiella pneumoniae, Escherichia coli, Haemophilus influenzae, Enterobacter cloacae and Salmonella were highly sensitive to meropenem and imipenem. Conclusion In the antimicrobial drug treatment of children with hip septic arthritis, the etiology sample should be collected for drug susceptibility analysis. Empirical drug therapy strategy should be applied in the absence of the analysis results. Sensitive antibiotic drug therapy should be used after obtaining reliable etiological diagnosis and drug susceptibility results, and simultaneously taking the age into consideration.
出处
《国际生物医学工程杂志》
CAS
2017年第6期432-436,共5页
International Journal of Biomedical Engineering
基金
Major Program of Medical Science Research of Hebei Province (20150569)
河北省医学科学研究重点课题计划(20150569)
关键词
儿童
髋关节
化脓性关节炎
耐药性
抗生素
药物敏感实验
Children
Hip joint
Septic arthritis
Drug resistance
Antibiotic
Drug susceptibility test