摘要
目的:了解儿童血流感染(BSI)的病原菌分布及对常用抗菌药物的敏感性。方法:回顾性分析2016年1月至2021年12月温州医科大学附属第二医院育英儿童医院BSI住院儿童临床资料、病原菌分布及药敏结果。结果:BSI患儿528例,检出病原菌538株,以革兰阳性菌为主(占55.4%),革兰阴性菌和真菌分别占42.2%和2.4%。检出前3位的病原菌是大肠埃希菌、凝固酶阴性葡萄球菌、肺炎链球菌。<1岁BSI儿童主要病原菌为大肠埃希菌,而≥1岁以肺炎链球菌为主。中央导管相关血流感染以表皮葡萄球菌为主要病原菌,占比36.1%。产超广谱β-内酰胺酶(ESBLs)的大肠埃希菌和肺炎克雷伯菌的构成比分别为50.8%和40.9%,产ESBLs大肠埃希菌对β-内酰胺酶类加酶抑制剂抗菌药物敏感性低于70.0%。耐甲氧西林表皮葡萄球菌(MRSE)和耐甲氧西林金黄色葡萄球菌(MRSA)的构成比分别为93.5%、54.5%,未发现对万古霉素、利奈唑胺耐药菌株。检出1株对利奈唑胺中介的粪肠球菌,1株对万古霉素中介的肺炎链球菌。结论:不同年龄儿童BSI病原菌分布不同。产ESBLs的大肠杆菌、肺炎克雷伯菌及MRSE、MRSA的占比高。应持续监测儿童BSI的病原菌分布及药敏结果,规范使用抗菌药物。
Objective:To study the distribution of pathogenic bacteria and antimicrobial susceptibility with bloodstream infections in children.Methods:Clinical data,distribution of pathogenic bacteria and antimicrobial susceptibility test results of children with bloodstream infections admitted to the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University from January 2016 to December 2021 were analyzed retrospectively.Results:A total of 538 pathogenic strains were detected in 528 cases,Gram-positive bacteria(55.4%),Gram-negative bacteria(42.2%)and fungi(2.4%)were detected,and the top 3 pathogens were Escherichia coli,coagulase-negative Staphylococcus,and Streptococcus pneumoniae.The main pathogens of bloodstream infections in children aged<1 years were Escherichia coli(30.6%),and Streptococcus pneumoniae(28.7%)was the main pathogen in≥1 year old.Central line-associated bloodstream infection was reported in 36 cases,with Staphylococcus epidermidis(36.1%)as the main pathogen.The proportion of producing extended spectrumβ-lactamases(ESBLs)of Escherichia coli and Klebsiella pneumoniae was 50.8%and 40.9%,respectively.The sensitivity of ESBLs-producing Escherichia coli to β-lactamase enzyme inhibitors was less than 70.0%.The proportion of methicillin-resistant Staphylococcus epidermidis(MRSE)and Staphylococcus aureus(MRSA)was 93.5% and 54.5%,respectively,and no strains resistant to vancomycin and linezolid were found.One strain of Enterococcus faecalis intermediate to linezolid and one strain of Streptococcus pneumoniae intermediate to vancomycin were detected.Conclusion:The distribution of BSI pathogenic bacteria varies among children at different ages.The proportion of ESBLs-producing Escherichia coli,Klebsiella pneumoniae,MRSE,MRSA is high.The distribution of pathogenic bacteria and antimicrobial susceptibility of bloodstream infections in children should be continuously monitored,and antimicrobial drugs should be used rationally.
作者
潘亚囡
周锦慧
章曼曼
毛慧宁
李思雨
韩昊
袁翔
涂慧茜
林立
PAN Ya’nan;ZHOU Jinhui;ZHANG Manman;MAO Huining;LI Siyu;HAN Hao;YUAN Xiang;TU Huixi;LIN Li(Department of Pediatric Respiratory Diseases,the Second Affiliated Hospital&Yuying Children’s Hospital of Wenzhou Medical University,Wenzhou 325027,China)
出处
《温州医科大学学报》
CAS
2023年第5期392-398,共7页
Journal of Wenzhou Medical University
基金
浙江省自然科学基金项目(LQ17H010003)
国家自然科学基金项目(81700011)。
关键词
儿童
血流感染
病原菌
耐药性
敏感性
children
bloodstream infection
pathogen
drug resistance
antimicrobial susceptibility
