宁波地区儿科重症监护室常见病原菌分布及耐药情况分析

目的了解宁波地区儿科重症监护病房(ICU)患儿感染病原菌分布及耐药情况,为儿童重症感染的控制和临床合理用药提供参考。方法对2015年1月~2016年12月我院儿科重症监护室住院患儿的送检标本进行常规培养分离,API系统鉴定菌株,药敏试验采用E-test法和K-B纸片法,采用WHONET5.6软件进行数据统计。结果 2015~2016年我院共筛选分离出病原菌849株。细菌检出率前五位分别为大肠埃希菌152株(17.90%)、肺炎克雷伯菌125株(14.72%)、鲍曼不动杆菌74株(8.36%)、金黄色葡萄球菌70株(8.24%)和洋葱伯克霍尔德菌54株(6.36%)。革兰氏阳性菌(G+)对青霉素G阳性率为85.54%,未发现万古霉素耐药菌株。革兰氏阴性菌(G-)对氨苄西林的耐药率为66.52%,对亚胺培南耐药率达5.04%。结论儿科重症监护室常见病原菌以革兰氏阴性菌为主,其中大肠埃希菌、肺炎克雷伯菌、鲍曼不动杆菌在儿科重症监护室分离率较高,耐药现象较为普遍,应动态监测其流行和耐药状况,为临床合理使用抗生素提供可靠依据。

Analysis of distribution and drug resistance of common pathogens in pediatric intensive care unit in Ningbo area

Objective To investigate the distribution and drug resistance of pathogens among children in pediatric intensive care unit (ICU) in Ningbo, in order to provide reference for the control and clinical rational drug use in children with severe infections. Methods Samples of children in pediatric intensive care unit in our hospital from January 2015 to December 2016 were routinely cultured and isolated. Strains were identified through the API system and susceptibility testing was conducted using E-test method and K-B paper disk method. WHONET 5.6 software were used for data statistics. Results A total of 849 strains of pathogens were isolated in our hospital from 2015 to 2016. The top five bacteria detected were Escherichia coli of 152 strains (17.90%), Klebsiella pneumonia of 125 strains (14.72%), Acinetobacter baumanni of 74 strains(8.36%), Staphylococcus aureus of 70 strains(8.24%) and Burkholderia cepacia of 54 strains(6.36%). The positive rate of Gram-positive bacteria(G+) to penicillin G was 85.54%. No vancomycin-resistant strains were found. The resistance rate of Gram-negative bacteria(G-) was 66.52% to ampicillin, and 5.04% to imipenem. Conclusion Gram-negative bacteria were the most common pathogens in pediatric intensive care unit, among which Escherichia coli, Klebsiella pneumoniae and Acinetobacter baumannii had a high separation rate. Drug resistance is common and its epidemic and drug resistance should be monitored dynamically, so as to provide a reliable basis for clinical rational use of antibiotics.