摘要
目的比较儿科重症监护病房(PICU)与普通病房及门诊(非PICU)患儿血培养阳性的病原菌分布及耐药性特点,为临床合理用药提供参考依据。方法回顾性分析,2016年我院PICU与非PICU血培养阳性的病原学资料,利用SPSS 19.0统计软件进行数据处理。结果共分离出病原菌914株,其中PICU 101株(11.05%),非PICU 813株(88.95%)。革兰阳性菌551株(60.28%),以表皮葡萄球菌和人葡萄球菌多见;革兰阴性菌331株(36.21%),以大肠埃希菌和肺炎克雷伯菌多见。PICU与非PICU比较,除肺炎克雷伯菌外,其他病原菌无统计学差异(P>0.05)。2组中表皮葡萄球菌对左氧氟沙星、环丙沙星、庆大霉素、利福平的耐药率存在统计学差异(P<0.05);大肠埃希菌对头孢噻肟、头孢他啶、左氧氟沙星、美洛培南、哌拉西林/他唑巴坦、头孢哌酮/舒巴坦以及亚胺培南的耐药率存在统计学差异(P<0.05);肺炎克雷伯菌对头孢呋辛酯、头孢唑林、头孢曲松、头孢呋辛、头孢孟多、四环素、庆大霉素的耐药率存在统计学差异(P<0.05)。结论 2组血培养阳性标本中分离出的革兰阳性菌均以表皮葡萄球菌和人葡萄球菌多见,革兰阴性菌以大肠埃希菌和肺炎克雷伯菌多见;2组耐药情况均较严峻,但对一部分抗菌药物耐药性存在差异,应引起高度重视。
Objective To conduct a comparative analysis of the distribution and antibiotic resistance characteristics of pathogenic bac-teria among patients with positive blood cultures in the pediatric intensive care unit （PICU） ,and those in the general ward and outpatient department （non-PICU） . Methods A retrospective analysis was performed to collect and compare the pathogenic data of patients with positive blood cultures in the department of pediatrics in the PICU and non-PICU in our hospital in 2016. Results A total of 914 strains of pathogenic bacteria was isolated,including 101 strains from the PICU （11.05%） and 813 strains from the non-PICU （88.95%） . Among these strains,551 were Gram-positive bacteria （60.28%） ,most of which were Staphylococcus epidermidis （S. epidermidis） and Human staphylococcus,along with 331 strains of Gram-negative bacteria （36.21%） ,which were mostly Escherichia coli （E. coli） and Klebsiella pneumoniae （K. pneumoniae） . The drug resistance rates of S. epidermidis to levofloxacin,ciprofloxacin,gentamicin,and rifampin （ P 〈 0.05）; E. coli to cefotaxime,ceftazidime,levofloxacin,meropenem,piperacillin/tazobactam,cefoperazone/sulbactam,and imipenem （P 〈 0.05）;and K. pneumoniae to cefuroxime,cefazolin,ceftriaxone,cefuroxime,cefamandole,tetracycline,and gentamicin （P 〈 0.05） were statistically significant. Conclusion Gram-positive bacteria isolated from the pediatric positive blood culture specimens were mostly S. epidermidis and Human Staphylococcus,and the Gram-negative bacteria were mainly E. coli and K. pneumoniae,both in the PICU and non-PICU. The pathogenic bacteria showed severe drug resistance,and a statistically significant difference in drug resistance to some com-monly used antibiotics was found between the 2 groups.
作者
岳冬梅
佟雅洁
杨凡
YUE Dongmei;TONG Yajie;YANG Fan(Department of Pediatrics,Shengjing Hospital,China Medical University,Shenyang 110004,China)
出处
《中国医科大学学报》
CAS
CSCD
北大核心
2018年第6期537-541,547,共6页
Journal of China Medical University
基金
辽宁省自然科学基金(201602873)
关键词
儿科
重症监护病房
普通病房
门诊
血培养
病原菌
耐药性
pediatrics
intensive care unit
general wards
outpatient department
blood culture
pathogenic bacteria
drug resistance
