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目的:了解我院儿科病区的病原菌分布及耐药情况,为抗菌药物的合理使用提供依据。方法:对2013年10月至2015年5月我院儿科病区分离的病原菌及其耐药性进行回顾性分析与总结。结果:1 564份标本共检出病原菌327株,阳性率为20.9%;其中革兰阳性菌占52.6%,革兰阴性菌占44.3%,真菌占3.1%。排名前5位的病原菌依次为肺炎链球菌(25.4%)、金黄色葡萄球菌(16.5%)、大肠埃希菌(14.7%)、肺炎克雷伯菌(8.6%)和流感嗜血杆菌(6.1%)。革兰阳性菌对红霉素和青霉素的耐药率较高,其中肺炎链球菌对红霉素和青霉素的耐药率分别为95.5%和62.1%;革兰阴性菌对第三、四代头孢菌素、单环β-内酰胺类、碳青霉烯类等的耐药率较低,其中大肠埃希菌和肺炎克雷伯菌对头孢他啶的耐药率分别为8.8%和25.0%。多重耐药肺炎链球菌、表皮葡萄球菌、阴沟肠杆菌的检出率分别为45.6%、87.5%和35.7%,耐甲氧西林金黄色葡萄球菌(MRSA)的检出率为18.4%,产超广谱β-内酰胺酶(ESBLs)大肠埃希菌和肺炎克雷伯菌的检出率为53.5%和38.5%。结论:我院儿科病区以革兰阳性球菌感染为主,多重耐药肺炎链球菌的检出率较高,应加强抗菌药物使用的监管,减少耐药菌株的产生。
Objective: To understand the distribution and drug resistance of pathogenic bacteria in pediatric ward in our hospital, and to provide basis for the rational use of antibacterial drugs. Methods: The pathogen and drug resistance of pediatric ward isolated from October 2013 to May 2015 were retrospectively analyzed and summarized. Results: A total of 327 strains of pathogens were detected in 5684 samples, the positive rate was 20.9%. Gram-positive bacteria accounted for 52.6%, gram-negative bacteria accounted for 44.3% and fungi accounted for 3.1%. The top five pathogens were S. pneumoniae (25.4%), Staphylococcus aureus (16.5%), Escherichia coli (14.7%), Klebsiella pneumoniae (8.6%) and Haemophilus influenzae %). Gram-positive bacteria had a higher resistance rate to erythromycin and penicillin, of which Streptococcus pneumoniae to erythromycin and penicillin resistance rates were 95.5% and 62.1%; Gram-negative bacteria on the third and fourth generations of cephalosporins The resistance rates of mycotoxins, monocyclic β-lactams and carbapenems were relatively low. The resistance rates of Escherichia coli and Klebsiella pneumoniae to ceftazidime were 8.8% and 25.0%, respectively. The detection rates of multidrug-resistant Streptococcus pneumoniae, Staphylococcus epidermidis and Enterobacter cloacae were 45.6%, 87.5% and 35.7% respectively. The detection rate of methicillin-resistant Staphylococcus aureus (MRSA) was 18.4% The detection rates of extended spectrum β-lactamases (ESBLs) Escherichia coli and Klebsiella pneumoniae were 53.5% and 38.5%, respectively. CONCLUSIONS: Gram-positive cocci infection is the major cause of pediatric endemic diseases in our hospital. The detection rate of multidrug-resistant Streptococcus pneumoniae is high. The use of antibacterials should be strengthened to reduce the production of drug-resistant strains.