儿科败血症分离菌582株细菌谱及耐药性分析

目的:探讨儿科败血症细菌谱的改变和耐药性的变迁,为临床合理选择抗生素提供依据。方法:对2005~2010年582例败血症患儿血培养阳性分离菌株的细菌谱及耐药性进行回顾性分析,将2005~2007年的263例患儿设为A组、2008~2010年的319例患儿设为B组,比较2组细菌谱及耐药性的变化。结果:共分离菌株582株,其中革兰阳性菌358株(61.5%),革兰阴性菌188株(32.3%),念珠菌8株(1.4%),其他28株(4.8%);凝固酶阴性葡萄球菌51.2%、大肠埃希菌20.4%、金黄色葡萄球菌6.4%、肺炎克雷伯杆菌3.4%、肠杆菌3.4%。B组分离菌株对常用抗生素耐药率高于A组分离菌株,超广谱β-内酰胺酶阳性株增加。结论:儿科败血症病原菌以革兰阳性菌为主,并有逐渐增长趋势;随着广谱抗生素的应用,细菌的耐药性增加明显。

Analysis of bacterial spectrum isolated from the blood culture of 582 pediatric septicemias and its drug resistance

Objective：To explore the changes of bacterial spectrum and its resistance in pediatric sepsis so as to provide basis for correct use of antibiotics.Methods：The bacteria strains detected in the blood culture of children suffering from sepsis from 2005 to 2010 and the drug sensitivity were studied retrospectively.The patients admitted from 2005 to 2007 were included in Group A and patients admitted from 2008 to 2010 were in group B.The changes of bacterial spectrum and the drug resistance were compared between the two groups.Results：Five hundred and eighty-two strains were isolated,among which the Gram-positive bacteria accounted for 358（61.5%）,the Gram-negative bacteria 188（32.3%）,the Candida 8（1.4%） and others 28（4.8%）.The major strains included coagulase-negative Staphylococci（51.2%）,Escherichia coli（20.4%）,Staphylococcus aureus（6.4%）,Klebsiella pneumoniae（3.4%） and Enterobacter（3.4%）.The drug resistance of group B to common antibiotics was higher than that of group A;meanwhile,the positive strains of extended-spectrum β-lactamases had a tendency to increase.Conclusions：The gram-positive bacterium is the main pathogen in pediatric septicemia and has a tendency to increase.With the application of broad-spectrum antibiotics,the drug resistance increases significantly.