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目的了解2012-2014年宜昌城区儿童细菌感染病原菌分布及各病原菌的耐药性变迁情况。方法从LIS系统中收集2012-2014年细菌培养阳性且符合细菌感染特征的病例404例,对培养及药敏试验结果进行回顾性分析。结果 272例患儿血培养中共分离出141株细菌,构成比前5位分别为表皮葡萄球菌46.81%(66/141)、溶血葡萄球菌12.77%(18/141)、洋葱伯克霍尔德菌10.64%(15/141)、大肠埃希菌5.67%(8/141)和肠球菌4.96%(7/141)。132例患儿一般细菌培养共分离出72株细菌,构成比前5位分别为大肠埃希菌33.33%(24/72)、金黄色葡萄球菌11.11%(8/72)、假单胞菌属9.72%(7/72)、肺炎克雷伯菌8.33%(6/72)、肠球菌和溶血葡萄球菌(均为6.94%)(5/72)。耐药率处于前5位分别为青霉素96.33%、哌拉西林84.38%、红霉素82.71%、头孢曲松和头孢呋辛(均为81.25%),统计病例中未发现对万古霉素和泰能耐药的病原菌。结论 2012-2014年宜昌城区儿童病原菌谱主要以革兰阳性凝固酶阴性的葡萄球菌和革兰阴性的大肠埃希菌为主,对普通青霉素类及四代以前头孢类耐药率较高。
Objective To understand the distribution of pathogenic bacteria in children with Yichang from 2012 to 2014 and the changes of drug resistance in each pathogen. Methods A total of 404 cases with positive bacterial cultures and consistent with bacterial infection were collected from LIS system from 2012 to 2014. The results of culture and drug susceptibility tests were retrospectively analyzed. Results A total of 141 strains of bacteria were isolated from blood cultures of 272 children, accounting for 46.81% (66/141) of Staphylococcus epidermidis, 12.77% (18/141) of Staphylococcus haemolyticus and Burkholderia cepacia 10.64% (15/141), Escherichia coli 5.67% (8/141), and Enterococcus (4.96%) (7/141). A total of 72 strains of bacteria were isolated from 132 bacterial cultures in general, accounting for 33.33% (24/72), 11.11% (8/72) of the total, 5 strains of Pseudomonas 9.72% (7/72), Klebsiella pneumoniae 8.33% (6/72), Enterococcus and Staphylococcus haemolyticus (both 6.94%) (5/72). The first five strains were resistant to penicillin 96.33%, piperacillin 84.38%, erythromycin 82.71%, ceftriaxone and cefuroxime (both 81.25%). No statistical difference was found between vancomycin and Thai Resistant to pathogens. Conclusion The prevalence of gram-positive coagulase-negative Staphylococcus aureus and Gram-negative Escherichia coli in Yichang City from 2012 to 2014 were mainly based on the high prevalence of common penicillins and four generations of cephalosporins.