【摘要】 目的了解医院2007-2009年小儿血培养病原菌菌群分布及其耐药性。方法 3522份小儿血标本经BACTEC 9120全自动血培养仪培养检测,分离出的病原菌用API半自动微生物鉴定系统进行鉴定及药敏试验。结果共分离出212株病原菌,血培养阳性率6.02%,其中革兰阳性菌145株,占68.4%,革兰阴性菌67株,占31.6%,检出前5位的病原菌依次为:凝固酶阴性葡萄球菌、沙门菌属、大肠埃希菌、肠球菌属、克雷伯菌属,分别占49.5%、10.8%、8.0%、7.6%、6.6%;各主要致病革兰阳性菌对万古霉素敏感;葡萄球菌属的耐药情况严重,对苯唑西林、青霉素、红霉素及庆大霉素的耐药率>75.0%,肠球菌属对青霉素与左氧氟沙星耐药率为100.0%,链球菌属对克林霉素和红霉素的耐药率为100.0%;常见革兰阴性菌对头孢呋辛与头孢噻吩均耐药,各主要致病革兰阴性菌对亚胺培南、美罗培南、奈替米星、头孢他啶、阿莫西林/克拉维酸及哌拉西林/他唑巴坦敏感。结论小儿血培养病原菌以革兰阳性菌占优势,凝固酶阴性葡萄球菌居首位,检出菌均存在严重耐药问题,及时监测病原菌变化及耐药趋势以指导临床用药至关重要。更多还原

【Abstract】 OBJECTIVE To investigate the distribution of pathogenic bacteria detected from the children′s blood culture and to observe the drug resistance of common pathogenic bacteria during the last three years in our hospital.METHODS 3522 children′s blood samples were cultured and detected by the BACTEC 9120,and the API half-automicroscan system was used to identify the pathogenic bacteria and their drug resistance.RESULTS Totally 212 pathogenic bacteria were isolated.The positive rate was 6.02%.Gram-positive bacteria remained the more frequent pathogens than Gram-negative bacteria.The most common organism causing bloodstream infections was coagulase-negative Staphylococcus(49.5% of the isolates),Salmonella,Escherichia,Enterococcus and Klebsiella were next in order among the isolates,accounting for 10.8%,8.0%,7.6% and 6.6%,respectively.The dominant Gram-positive pathogenic bacteria were sensitive to vancomycin.Staphylococcus was resistant against various antibiotics obviously and the resistance rate of Staphylococcus to oxacillin,penicillin,erythromycin and gentamicin was over 75.0%.Enterococcus was resistant against most antibiotics obviously,and the resistance rate of Enterococcus to penicillin and levofloxacin was 100.0%.And the resistance rate of Streptococcus to clindamycin and erythromycin was 100.0%.The dominant Gram-negative pathogenic bacteria were resistant to Cefuroxime and cephalothin.and the dominant Gram-negative pathogenic bacteria were sensitive to imipenem,meropenem,netilmicin,ceftazidime,amoxicillin/clavulanic acid and piperacillin/tazobactam.CONCLUSIONS Gram-positive bacteria are the predominant pathogents of children′s patients with septicemia and CNS ranks first on the list.Drug resistance of isolated pathogenic bacteria is a serious problem.Monitoring the change of pathogen and the trends of antimicrobial are very important in guiding the clinical administration of drugs.更多还原