摘要
目的了解深圳地区儿童临床分离菌的菌种分布及耐药性,为临床诊治提供指导。方法对深圳市儿童医院2017年临床分离细菌采用纸片扩散法、微量肉汤稀释法和自动化仪器法进行抗菌药物敏感性试验。结果全年该院临床分离细菌共10487株,其中革兰阳性菌占38.9%,革兰阴性菌占61.1%。肺炎链球菌非脑膜炎分离株对青霉素耐药率较低(0.3%);金黄色葡萄球菌(金葡菌)和凝固酶阴性葡萄球菌中甲氧西林耐药株(MRSA和MRCNS)的检出率分别为34.7%和78.8%,MRSA和MRCNS对大多数受试药物的耐药率均显著高于甲氧西林敏感葡萄球菌(MSSA和MSCNS);屎肠球菌对大多数受试药物的耐药率高于粪肠球菌;未发现万古霉素或利奈唑胺耐药的革兰阳性球菌。大肠埃希菌和肺炎克雷伯菌中产ESBL菌株的检出率分别为46.8%和41.1%,对头孢替坦、亚胺培南、厄他培南和阿米卡星的耐药率均较低(<5%);沙门菌属对氨苄西林耐药率较高(82.3%);铜绿假单胞菌和鲍曼不动杆菌对受试药物耐药率较低(<8%)。卡他莫拉菌和流感嗜血杆菌β内酰胺酶阳性检出率分别为98.8%和54.6%,其中β内酰胺酶阴性氨苄西林耐药的流感嗜血杆菌的检出率为4.6%。结论由于儿童群体的特殊性和治疗所能选择药物的有限性,使得儿童细菌感染性疾病的病原谱和耐药谱有异于成人,因此定期开展儿童细菌耐药监测工作十分必要。
Objective To investigate the distribution and antibiotic resistance profile of clinical isolates in Shenzhen Children's Hospital for better clinical diagnosis and treatment.Methods Antimicrobial susceptibility test was conducted using Kirby-Bauer method,broth microdilution method,and automated Systems.Results A total of 10 487 clinical isolates were collected in the hospital throughout the year,of which gram-positive bacteria accounted for 38.9% and gram-negative bacteria accounted for 61.1%. The non-meningitis S.pneumoniae isolates showed low resistance rate to penicillin (0.3%).The prevalence of methicillin-resistant strains (MRSA and MRCNS) in S.aureus and coagulase-negative Staphylococcus was 34.7% and 78.8%,respectively.The resistance rates of MRSA and MRCNS to most of the drugs tested were significantly higher than those of MSSA and MSCNS.E.faecium was more resistant to most of the antibiotics tested than E.faecalis.Vancomycin- or linezolid-resistant strains were not identified in grampositive cocci.ESBLs-producing strains accounted for 46.8% and 41.1% in E.coli and K.pneumoniae isolaets,respectively. These strains showed low resistance rate to cefotetan, imipenem,ertapenem,and amikacin (<5%).Salmonella strains showed high resistance rate to ampicillin (82.3%).No carbapenem-resistant strain was detected.P.aeruginosa and A. baumannii showed low resistance rate (<8%) to the antimicrobial agents tested.The prevalence of beta-lactamase positive strains was 98.8% in M.catarrhalis and 54.6% in H.influenzae.The prevalence of beta-lactamase negative ampicillin-resistant (BLNAR) Haemophilus influenzae was 4.6%.Conclusions The spectrum and antimicrobial resistant pattern of pathogens in children are different from those in adults.Therefore,it is necessary to implement ongoing surveillance of bacterial resistance in children.
作者
孟青
陈运生
崔晓燕
陈虹宇
孙丽芳
杨庆斌
胡付品
MENG Qing;CHEN Yunsheng;CUI Xiaoyan;CHEN Hongyu;SUN Lifang;YANG Qingbin;HU Fupin(Department of Laboratory Medicine,Shenzhen Children's Hospital,Shenzhen Guangdong 518038,China)
出处
《中国感染与化疗杂志》
CAS
CSCD
北大核心
2019年第4期417-424,共8页
Chinese Journal of Infection and Chemotherapy
关键词
细菌耐药监测
药物敏感性试验
甲氧西林耐药葡萄球菌
流感嗜血杆菌
bacterial resistance surveillance
antimicrobial susceptibility testing
methicillin-resistant Staphylococcus
Haemophilus influenzae
